Search

AbstractObjective: Suicide is a leading cause of death globally. Clinical neuropsychologists may see patients at increased risk of suicide who may have had no prior engagement with another mental health provider. Even if their role is limited to a single encounter, neuropsychologists can still incorporate specific practices (e.g. into their interview appointment) that help reduce a patient’s suicide risk. Method: This review aims to highlight current best practices for suicide risk assessment and management, emphasizing the crucial role neuropsychologists can play in suicide prevention. Conclusions: Neuropsychologists’ involvement in healthcare systems positions them to implement effective suicide prevention strategies, including the Zero Suicide (ZS) framework. The ZS framework is a systematic approach to improve suicide prevention through the implementation of evidence- based strategies including specific strategies to use when working with patients (i.e. identify, engage, treat, and transition). Effective screening tools for suicidal thoughts and behaviors include the Columbia-Suicide Severity Rating Scale (C-SSRS) and the Ask Suicide-Screening Questions (ASQ) Toolkit. Brief interventions that can be incorporated into an assessment appointment, such as safety planning and means safety interventions, demonstrate significant reductions in suicidal behavior and improved engagement with mental health treatment. Neuropsychologists can refer patients to evidence-based treatments that directly target suicide risk and support at-risk patients through transitions in care by employing strategies like Caring Contacts and structured follow-up calls. By integrating these best practices and engaging in continuous education, neuropsychologists can significantly contribute to reducing suicide risk among their patients. [ABSTRACT FROM AUTHOR]

No study to date has examined the moderating effect of parenthood on suicidal states and outcomes using a conditional process model. The Narrative Crisis Model, a multi‐stage model from interpersonal distress to suicidal outcomes mediated by Suicide Crisis Syndrome severity, was assessed (H1). The present study tested whether (H2) parenthood moderates the indirect association between interpersonal distress and suicidality to reduce suicide risk. Psychiatric outpatients (N = 466) completed measures assessing the severity of interpersonal distress and Suicide Crisis Syndrome, as well as a clinical interview of suicidal thoughts and behaviors. The sample was predominantly female (65.7%), with ages ranging from 18 to 84 years. Mediation was conducted on the total sample (H1) and a conditional process analysis compared parents (n = 170) and non‐parents (H2). Suicide Crisis Syndrome severity mediated the relationship between interpersonal distress and suicidal outcomes. Parenthood moderated the indirect relationship between interpersonal distress and suicidal outcomes through Suicide Crisis Syndrome such that parents had a significantly higher suicide risk than non‐parents (index = 0.058; 95% CI [0.005, 0.139]). In the context of an outpatient population, parents appear to be more at risk for developing a suicidal crisis and engaging in suicidal thoughts and behaviors than non‐parents. Parenthood may act as a pile‐up stressor for this population, outweighing the protective effects of having children. In this way, the Narrative Crisis Model is a theoretical model suitable for the examination of complex factors impacting risk for near‐term suicidal thoughts and behaviors. [ABSTRACT FROM AUTHOR]

Military sexual assault (MSA) is a prevalent issue among military personnel that has been linked to adverse mental and physical health outcomes, including posttraumatic stress disorder (PTSD) and suicidal thoughts and behaviors. The present study sought to investigate the relationship between MSA and nonsuicidal self-injury (NSSI) in a national sample of Gulf War-I Era U.S. veterans. The study analyzed data from 1,153 Gulf War-I veterans collected through a cross-sectional survey that assessed demographic information, clinical outcomes, military background, and history of MSA and NSSI. MSA was found to be significantly associated with NSSI at the bivariate level (OR = 2.19, p <.001). Further, MSA remained significantly associated with NSSI (AOR = 2.50, p =.002) after controlling for relevant demographics and clinical outcomes. Veterans with a history of MSA were approximately two and half times more likely to engage in NSSI than veterans who had not experienced MSA. The present findings provide preliminary evidence linking MSA and NSSI. Further, the findings highlight the importance of assessing MSA and NSSI in veteran populations, particularly among those seeking treatment for PTSD. [ABSTRACT FROM AUTHOR]

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

Background: Men are up to four times more likely to die by suicide than women. At the same time, men are less likely to disclose suicidal ideation and transition more rapidly from ideation to attempt. Recently, socialized gender norms and particularly conformity to masculine norms (CMN) have been discussed as driving factors for men's increased risk for suicidal thoughts and behaviors (STBs). This study aims to examine the individual interplay between CMN dimensions and their association with depression symptoms, help-seeking, and STBs. Methods: Using data from an anonymous online survey of 488 cisgender men, latent profile analysis was performed to identify CMN subgroups. Multigroup comparisons and hierarchical regression analyses were used to estimate differences in sociodemographic characteristics, depression symptoms, psychotherapy use, and STBs. Results: Three latent CMN subgroups were identified: Egalitarians (58.6 %; characterized by overall low CMN), Players (16.0 %; characterized by patriarchal beliefs, endorsement of sexual promiscuity, and heterosexual self-presentation), and Stoics (25.4 %; characterized by restrictive emotionality, self-reliance, and engagement in risky behavior). Stoics showed a 2.32 times higher risk for a lifetime suicide attempt, younger age, stronger somatization of depression symptoms, and stronger unbearability beliefs. Conclusion: The interplay between the CMN dimensions restrictive emotionality, self-reliance, and willingness to engage in risky behavior, paired with suicidal beliefs about the unbearability of emotional pain, may create a suicidogenic psychosocial system. Acknowledging this high-risk subgroup of men conforming to restrictive masculine norms may aid the development of tailored intervention programs, ultimately mitigating the risk for a suicide attempt.

Suicide is a leading cause of death among youth on the psychosis spectrum. Internalized mental health stigma is one risk factor for suicide that may be particularly salient for youth with psychosis-risk syndromes and early psychosis. Among this population, Black youth may face exposure to racism-related stressors that may exacerbate the negative effects of internalized stigma. This study examined whether internalized stigma and race interact to predict suicidal thoughts and behaviors (STB) in a help-seeking sample of Black and White adolescents with psychosis-risk syndromes and early psychosis. Findings suggest that Black youth with early psychosis spectrum disorders may be particularly vulnerable to the negative effects of internalized stigma as they pertain to STB. Internalized stigma may therefore represent an important treatment target in suicide prevention efforts among this population.

Background: Major depressive disorder (MDD) contributes to suicide risk. Treating MDD effectively is considered a key suicide prevention intervention. Yet many patients with MDD do not respond to their initial medication and require a 'next-step'. The relationship between next-step treatments and suicidal thoughts and behaviors is uncharted. Method: The VA Augmentation and Switching Treatments for Depression trial randomized 1522 participants to one of three next-step treatments: Switching to Bupropion, combining with Bupropion, and augmenting with Aripiprazole. In this secondary analysis, features associated with lifetime suicidal ideation (SI) and attempts (SA) at baseline and current SI during treatment were explored. Results: Compared to those with SI only, those with lifetime SI + SA were more likely to be female, divorced, or separated, unemployed; and to have experienced more childhood adversity. They had a more severe depressive episode and were more likely to respond to 'next-step' treatment. The prevalence of SI decreased from 46.5% (694/1492) at baseline to 21.1% (315/1492) at end-of-treatment. SI during treatment was associated with baseline SI; low positive mental health, more anxiety, greater severity and longer duration of current MDD episode; being male and White; and treatment with S-BUP or C-BUP as compared to A-ARI. Conclusion: SI declines for most patients during next-step medication treatments. But about 1 in 5 experienced emergent or worsening SI during treatment, so vigilance for suicide risk through the entire 12-week acute treatment period is necessary. Treatment selection may affect the risk of SI. [ABSTRACT FROM AUTHOR]

Background: Digital self‐harm (DiSH) is a recently identified self‐harm distinct from physical self‐harm (PSH, also known as non‐suicidal self‐injury, NSSI). Although prior research has shown that DiSH was associated with suicidal thoughts and behaviors (STBs), it was still unclear whether DiSH has a unique association with STBs after controlling for PSH. Method: A cross‐sectional survey was conducted on Chinese college students. The lifetime prevalence of DiSH and PSH, the functions of DiSH, recent suicide experiences (including suicide ideation, plans, and attempts), anxiety and depression were examined. A total of 5281 participants were analyzed. Results: A total of 10.83% of participants had ever engaged in DiSH, and 1.59% of participants reported histories of both DiSH and PSH. Among participants with a history of PSH, 30.11% engaged in DiSH. Engagement in DiSH was significantly associated with suicide ideation (SI), suicide plans (SPs), and suicide attempts (SAs). More importantly, participants who engaged in both DiSH and PSH showed higher odds of SI and SPs compared to those who had only engaged in PSH. Regarding the functions of DiSH, using DiSH for self‐punishment was associated with SI and SPs, and using DiSH for sensation seeking was associated with SPs and SAs. Similar results were found for the association between DiSH and anxiety and depression. Conclusions: Our findings suggest that DiSH has a unique association with the risks of STBs beyond PSH. Early identification and intervention for DiSH are crucial, even for individuals who already engage in PSH. [ABSTRACT FROM AUTHOR]

Introduction: Depressive and mixed symptoms in bipolar disorder (BD) have been linked to higher suicide risk. Based on Klonsky and May's three‐step theory and Joiner's Interpersonal Psychological Theory of Suicide, we hypothesized that patients diagnosed with BD who reported severe levels of depressive symptoms and mixed depressive and manic symptoms would also report higher levels of suicidal desire and acquired capability of suicide, as well as suicidal thoughts and behaviors. Methods: The sample included 177 outpatients diagnosed with BD. Latent class analysis was conducted to replicate the identified groups of a previously conducted study using a smaller but overlapping dataset. Between‐class and pairwise analyses with measures of suicidal desire and acquired capability were conducted. Results: As expected, the classes characterized by severe depressive symptoms and mixed symptoms reported higher levels of suicidal desire. However, the results regarding acquired capability were less consistent. Conclusion: Given the overall elevated suicide risk of BD and the consistent relationship between depressive symptoms and other strong correlates of suicide, clinicians who work with patients diagnosed with BD should closely monitor changes in their depressive symptoms. [ABSTRACT FROM AUTHOR]

IntroductionDespite the extensive implementation of suicide prevention strategies targeting suicidal thoughts and behaviors (STB) in adolescents, there remains a concerning lack of improvement in the situation. In this comprehensive scoping review, our objective was to provide insights into prevention methods for suicidal thoughts and behaviors directed towards adolescents, including their effectiveness, public perception, and potential adaptations.MethodA scoping review was conducted, encompassing 71 articles including systematic review, clinical trials and qualitative studies for a wider understanding. Most articles included focus generally on adolescents aged 10–20.ResultsNo single intervention has shown expected effectiveness, collective efforts have laid a solid foundation for suicide prevention. Promising interventions include cognitive-behavioral therapy (CBT) and incorporating Technology-based interventions. However, challenges persist in promoting help-seeking behaviors and addressing barriers such as stigma, the natural impulsive nature of adolescents and difficulty in selecting and defining data and designs.DiscussionThis review underscores the need for a holistic approach to suicide prevention, integrating social, emotional, and psychological dimensions. Successful interventions target underlying issues like depression and loneliness rather than solely focusing on suicidal thoughts and behaviors (STB). Combining direct and indirect interventions is a sensible approach for both immediate and long-term results. Understanding Generation Z's unique needs, influenced by technology and diverse perspectives, is crucial for effective prevention.ConclusionInvolving adolescents and adopting patient-centered healthcare with outcome measures like Patient Perceived Outcome Measures can enhance suicide prevention efforts by prioritizing safety and patient experiences.

Background: Despite severely burdened individuals, often being excluded from research studies on internet- and mobile-based interventions (IMIs), negative events (NEs) including suicidal thoughts and behaviors (STBs) can still occur during a trial. NEs require monitoring and adequate safety measures. However, study protocols frequently lack comprehensive descriptions of procedures for managing NEs. Aims: This study aimed to illustrate the assessment, monitoring, and procedures for addressing NEs in two studies on IMIs in adults and youth using case reports, to identify strengths and weaknesses of the NE management approaches, and to derive key learnings and recommendations. Methods: Two case reports were drawn from two distinct IMI studies. The first study, PSYCHOnlineTHERAPY, evaluates the combination of an IMI with on-site psychotherapy for anxiety and depressive disorders in adults (adult blended study). The second study evaluates a standalone, therapist-guided IMI for post-traumatic stress disorder (PTSD) in youth (youth standalone study). Potential NEs were predefined depending on the study sample. The case studies thoroughly document the systematic recording and ongoing monitoring of NEs through self-report and observer-based assessments during the interventions. The cases illustrate a variety of NE management strategies, including automated and personalized approaches, adapted to the specific nature and severity of the NEs. The NE management approaches are visualized using decision trees. Results: In the adult blended case study, online questionnaires detected STBs and triggered automated support information. As on-site therapy had already ended, a telephone consultation session allowed for the identification and discussion of the heightened intensity of suicidal thoughts, along with the development of specific additional help options. In the youth standalone case study, heightened tension in an adolescent with PTSD during trauma processing could be addressed in a telephone therapeutic session focusing on resource activation and emotion regulation. The referral to on-site treatment was supported. Overall, advantages of the NE management included automated procedures, multimodal assessment of a wide range of NEs, and standardized procedures tailored to different severity levels. Weaknesses included the use of single-item assessments for STBs and lack of procedures in case of deterioration or nonresponse to treatment. Conclusion: This study provides practical insights and derives key learnings and recommendations regarding the management of NEs in different IMI contexts for both adults and youth.

This study aimed to examine the role of parental monitoring and help seeking in the relationship between cyberbullying victimization and suicidal thoughts and behaviors in male and female college students. Data were collected for 336 college students (71.72% female and 28.28% male) aged 18 to 24 or older years from two universities in the Midwest and the South Central regions. Logistic regression indicated the interaction term of cyberbullying victimization and parental monitoring was negatively related to suicidal thoughts and behaviors in a male group (B = −.155, p <.05, Exp(B) =.86). Male students whose parents monitored about being safe on the computer had dramatically fewer suicidal thoughts/behaviors. In both male and female groups, seeking professional help was not a significant moderator that weakened the relationship. There is a need for additional research on the importance of prevention and intervention efforts to foster open dialogue between students and their parents. [ABSTRACT FROM AUTHOR]

To determine the incidence of suicidal ideation and suicide attempts (STBs) in veterans without an endorsed history of STBs and identify baseline predictors of these outcomes over a 10-year period. Population-based prospective cohort study of 2307 US military veterans using five waves of the 2011–2021 National Health and Resilience in Veterans Study. Baseline data were collected in 2011, with follow-up assessments conducted 2-(2013), 4-(2015), 7-(2018), and 10-years (2021) later. In total, 10.1 % (N = 203) of veterans endorsed incident suicidal ideation (SI) over the 10-year period and 3.0 % (N = 55) endorsed an incident suicide attempt (SA). Multivariable regression analyses revealed the following baseline predictors of incident SI: lower annual household income, current posttraumatic stress disorder, current alcohol use disorder (AUD), disability with activities of daily living (i.e., ADLs) or instrumental activities of daily living (i.e., IADLs), lower perceived social support, lower community integration, and lower purpose in life. Current AUD, greater cumulative trauma burden, and lower purpose in life at baseline were predictive of incident SA. Relative importance analyses revealed that lower purpose in life was the strongest predictor of both incident SI and SA. Psychosocial determinants of health, such as purpose in life, may be more reliable predictors of incident suicidal thoughts and behaviors than traditional risk factors (e.g., psychiatric distress; history of SA) in those without a history of STBs. Evidence-based interventions that facilitate purpose in life and feelings of connectedness and belonging should be examined as possible treatments for STBs. • Purpose in life (PIL) may protect against the development of suicidal thoughts and behaviors (STBs) in US Veterans. • Studies documenting the association between PIL and STBs have typically relied on convenience samples, cross-sectional designs, or relatively short follow-ups. • In this 10-year study, PIL emerged as the strongest predictor of both incident suicidal ideation and suicide attempts in US Veterans. [ABSTRACT FROM AUTHOR]

Abstract Background Juvenile legal involved youth (JLIY) experience disproportionately high rates of suicidal and self-injurious thoughts and behaviors (SSITB). Many JLIY lack access to evidence-based treatment specifically designed to treat SSITB, thereby increasing the overall risk of suicide. The overwhelming majority of JLIY are not placed in secure facilities and almost all incarcerated youth are eventually released to the community. Consequently, SSITB are a major concern of JLIY residing in the community and it is critical that this population has access to evidence-based treatment for SSITB. Unfortunately, most community mental health providers who treat JLIY have not been trained in evidence-based interventions that are specifically designed to SSITB, which often leads to youth experiencing prolonged periods of SSITB. Training community mental health providers who serve JLIY in the detection and treatment of SSITB shows promise for decreasing the overall suicide risk for JLIY. Methods The current proposal aims to reduce SSITB among JLIY, and thus reduce mental health disparities in this vulnerable and underserved youth population, by increasing access to evidence-based treatment strategies specifically designed to treat SSITB behaviors. We will implement an agency-wide training among at least 9 distinct community mental health agencies that serve JLIY referred to treatment by a statewide court system in the Northeast. Agencies will be trained in an adapted version of the COping, Problem Solving, Enhancing life, Safety, and Parenting (COPES+) intervention. Training will be implemented via a cluster-randomized stepped wedge trial that proceeds through multiple phases. Discussion This research engages multiple systems (i.e., juvenile legal and mental health systems) serving JLIY and has the potential to directly inform treatment practices in juvenile legal and mental health systems. The current protocol has significant public health implications as the primary goals are to reduce SSITB among adolescents involved in the juvenile legal system. By implementing a training protocol with community-based providers to help them learn an evidence-based intervention, this proposal aims to reduce mental health disparities in a marginalized and underserved population. Trial registration osf.io/sq9zt

Suicidal thoughts and behaviors (STBs) in elementary school-aged youth have increased in recent years. Understanding the risks associated with childhood STBs is necessary for prevention efforts. The current study examined clinical and neurocognitive characteristics of a community sample of elementary school-aged children with (STB+) and without (STB-) a history of STBs. The final sample included 93 families with children average age of 7.8 years (SD = 1.3). Children in this sample were racially diverse, evenly split by sex, and most identified as non-Hispanic. Neurocognitive functioning was assessed using computerized behavioral measures. Child clinical characteristics were assessed using self-report measures and STB history was assessed using semi-structured interviews. Of the 93 families, 64 STB- children and 29 STB+ children participated. On average, STB+ children were older, reported higher levels of depressive and anxiety symptoms, and were more likely to have a parental history of suicidal behavior (PH+). Regarding neurocognitive functioning, STB+ children exhibited lower raw scores for both the NIH Dimensional Change Card Sort Task (NIH-DCCS) and NIH Flanker Inhibitory Control and Attention Test (NIH-Flanker). Multivariable regression analyses revealed raw scores for NIH-DCCS and NIH-Flanker, PH+ status, and child age were associated with childhood STBs. Prospective data is needed to confirm cross-sectional findings. Poorer neurocognitive functioning and PH+ status may serve as risk markers for STBs in elementary school-aged children. Targeting prevention programming for these risks may reduce the likelihood of STBs in at-risk elementary school-aged youth. • Neurocognitive functioning of 6–9-year-old youth with and without a history of STBs • STB+ children exhibited more neurocognitive deficits compared to STB- children. • Parental history of SB, age, and neurocognitive functioning related to child STBs [ABSTRACT FROM AUTHOR]

Suicide among Black adolescent youth has steadily increased in recent years, yet few studies describe how facets of social identity shape suicidal thoughts and behaviors (STBs) during this critical stage of development. Ethnic identity represents an underexplored, yet important element of social identity among Black youth that may contribute to differential associations with STBs. This study examined the association between ethnic identity and self-reported suicidal ideation, planning, and attempts. Data were drawn from 1,170 African American (n = 810) and Caribbean Black (n = 368) adolescents aged 13–17 (Mean age = 15) that participated in the National Survey of American Life Adolescent supplement study. Using latent profile analyses, three patterns of ethnic identity were identified: Undifferentiated, Low Ethnic Identification, and Alienated. Caribbean Black adolescents were more likely to be in the Low Ethnic Identification class relative to the Undifferentiated class. Adolescents in the Undifferentiated group reported higher proportions of suicidal ideation, planning, and attempts compared to the remaining latent profile groups. Findings demonstrate that ethnic identity is an important aspect of social identity that can influence STBs among Black adolescents. Considering increased suicide attempts and death rates among Black youth, findings underscore the importance of examining culturally relevant developmental processes that may shape suicidal beliefs and behaviors. [ABSTRACT FROM AUTHOR]

Background: Although non-suicidal self-injury (NSSI) is known typically to begin in adolescence, longitudinal information is lacking about patterns, predictors, and clinical outcomes of NSSI persistence among emerging adults. The present study was designed to (1) estimate NSSI persistence during the college period, (2) identify risk factors and high-risk students for NSSI persistence patterns, and (3) evaluate the association with future mental disorders and suicidal thoughts and behaviors (STB). Methods: Using prospective cohorts from the Leuven College Surveys (n = 5915), part of the World Mental Health International College Student Initiative, web-based surveys assessed mental health and psychosocial problems at college entrance and three annual follow-up assessments. Results: Approximately one in five (20.4%) students reported lifetime NSSI at college entrance. NSSI persistence was estimated at 56.4%, with 15.6% reporting a high-frequency repetitive pattern (≥five times yearly). Many hypothesized risk factors were associated with repetitive NSSI persistence, with the most potent effects observed for pre-college NSSI characteristics. Multivariate models suggest that an intervention focusing on the 10–20% at the highest predicted risk could effectively reach 34.9–56.7% of students with high-frequency repetitive NSSI persistence (PPV = 81.8–93.4, AUC = 0.88–0.91). Repetitive NSSI persistence during the first two college years predicted 12-month mental disorders, role impairment, and STB during the third college year, including suicide attempts. Conclusions: Most emerging adults with a history of NSSI report persistent self-injury during their college years. Web-based screening may be a promising approach for detecting students at risk for a highly persistent NSSI pattern characterized by subsequent adverse outcomes. [ABSTRACT FROM AUTHOR]

Despite adolescents' suicidal thoughts and behaviors being major health problems, sparse literature exists on the roles of adolescents' disclosing their feelings to caregivers in their suicidal thoughts and behaviors. This study examined whether adolescents' comfort in disclosing their feelings and problems to caregivers predicts subsequent suicidal thoughts and behaviors and whether difficulties in emotion regulation mediate this association. High school students (N = 5,346 from 20 schools, 49% female-identified adolescents, and 35% 9th graders, 33% 10th graders, and 32% 11th graders) participated in the study for two years with four waves, each six months apart: fall semester in Year 1 (Wave 1), spring semester in Year 1 (Wave 2), fall semester in Year 2 (Wave 3), and spring semester in Year 2 (Wave 4). The degree to which adolescents felt comfortable disclosing their feelings and problems to caregivers at Wave 1 predicted lower suicidal thoughts and behaviors at Wave 4 directly and indirectly via higher emotional clarity at Wave 2 and feeling more able to handle negative emotions at Wave 3. Moreover, when female-identified adolescents reported feeling unable to handle negative emotions at Wave 3, they reported engaging in more suicidal thoughts and behaviors at Wave 4 than male-identified adolescents. Therefore, enhancing adolescents' comfort in disclosing their feelings and problems to caregivers and adolescent emotion regulation and taking a nuanced approach to support female-identified adolescents regarding their ability to handle negative emotions could prevent adolescents' suicidal thoughts and behaviors. [ABSTRACT FROM AUTHOR]

Knowledge gaps remain regarding whether syndemic conditions identify treatment-seeking individuals most at risk for suicidal thoughts and behaviors (STB). We employed latent class analysis to: (1) model treatment-seeking individuals' syndemic conditions, (2) examine latent classes across nonmedical social determinants, and (3) assess associations between class membership and STB. Participants were 982 individuals presenting at a community mental health clinic between October 2014 and February 2020. The three-step latent class analytic approach was used. Regression analyses were employed to examine nonmedical social determinants and STB outcomes associated with class membership. Participants were aged 18 to >72 (75.8% White; 76.7% heterosexual; 53.7% cisgender woman; 73.8% earned ≥$20,000 annually). Latent class analysis resulted in a three-class solution. Participants in Class 1 were characterized by low probabilities across syndemic conditions. Class 2 was characterized by high probabilities of anxiety and depression. Class 3 was characterized by high probabilities of eating disorders, anxiety, and depression. Participants of color, sexual minority participants, cisgender women, and those experiencing financial distress were more likely to be in classes characterized by syndemic conditions. Classes characterized by syndemic conditions, relative to no syndemic conditions, were associated with greater risk of STB. Findings confirm the concentrated clustering of co-occurring syndemic conditions among marginalized groups and highlight differing risks for those considering suicide or who have attempted suicide vs. those engaging in self-harm. Results underscore the need for resource allocation and multilevel interventions targeting syndemic conditions and suicidality for minority populations and those experiencing financial distress. [ABSTRACT FROM AUTHOR]

Background: Juvenile legal involved youth (JLIY) experience disproportionately high rates of suicidal and self-injurious thoughts and behaviors (SSITB). Many JLIY lack access to evidence-based treatment specifically designed to treat SSITB, thereby increasing the overall risk of suicide. The overwhelming majority of JLIY are not placed in secure facilities and almost all incarcerated youth are eventually released to the community. Consequently, SSITB are a major concern of JLIY residing in the community and it is critical that this population has access to evidence-based treatment for SSITB. Unfortunately, most community mental health providers who treat JLIY have not been trained in evidence-based interventions that are specifically designed to SSITB, which often leads to youth experiencing prolonged periods of SSITB. Training community mental health providers who serve JLIY in the detection and treatment of SSITB shows promise for decreasing the overall suicide risk for JLIY. Methods: The current proposal aims to reduce SSITB among JLIY, and thus reduce mental health disparities in this vulnerable and underserved youth population, by increasing access to evidence-based treatment strategies specifically designed to treat SSITB behaviors. We will implement an agency-wide training among at least 9 distinct community mental health agencies that serve JLIY referred to treatment by a statewide court system in the Northeast. Agencies will be trained in an adapted version of the COping, Problem Solving, Enhancing life, Safety, and Parenting (COPES+) intervention. Training will be implemented via a cluster-randomized stepped wedge trial that proceeds through multiple phases. Discussion: This research engages multiple systems (i.e., juvenile legal and mental health systems) serving JLIY and has the potential to directly inform treatment practices in juvenile legal and mental health systems. The current protocol has significant public health implications as the primary goals are to reduce SSITB among adolescents involved in the juvenile legal system. By implementing a training protocol with community-based providers to help them learn an evidence-based intervention, this proposal aims to reduce mental health disparities in a marginalized and underserved population. Trial registration: osf.io/sq9zt [ABSTRACT FROM AUTHOR]

Betrayal trauma is associated with dissociative symptoms, which can increase the risk of suicidal thoughts and behaviors. Previous research demonstrates associations between a mother's history of betrayal trauma and intergenerational patterns of maltreatment and dissociation among their children. However, maternal betrayal trauma history remains unexplored in the etiology of youth suicidality. This study was conducted to investigate pathways between maternal betrayal trauma and youth suicidality, while considering the influences of youth maltreatment exposure and symptoms of dissociation. We implemented conditional growth curve modeling in a structural equation modeling framework to analyze secondary data from the Longitudinal Studies of Child Abuse and Neglect (LONGSCAN; N = 1,354; 51.48% female, 53.29% Black). Predictors included mothers' betrayal trauma history, youth maltreatment exposure, and youth dissociative symptoms at ages 8, 12, and 16. The slope and intercept of dissociative symptoms at the age-8, age-12, and age-16 visit were modeled as latent factors. A robust weighted least squares estimator accounted for categorical outcomes. Indirect effects were assessed via the delta method. We found a significant indirect effect from maternal betrayal trauma to adolescent suicidal ideation through children's maltreatment exposure and the growth in children's dissociative symptoms from ages 8 through 16. Maternal betrayal trauma may play a unique role in perpetuating intergenerational patterns of trauma that contribute to subsequent trajectories of youth suicidality among their offspring. Practice implications for screening, prevention, and early intervention strategies are described, along with directions for further study. [ABSTRACT FROM AUTHOR]

Objective:To systematically evaluate the relationship between sleep problem and suicide thoughts and behaviors.Methods:A search was conducted in PubMed,Web of Science,Ovid PsysINFO,CNKI,Wanfang,VIP and CBM to explore the relationship between sleep problem and suicide thoughts and behaviors.The databases were searched from inception to February 3,2021 and the included literatures wereobservational study.Meta analysis will be performed using Stata 16.0 softwareto calculate combined odds radio（OR） and 95% CI.Results:Thirtyone literatures of 8287 with a total of 619 715 were included in the study.Results of the meta-analysis showed that in cross-sectional studies,sleep problems were positively associated with suicidal ideation,suicide plan,and suicide attempt（pooled ORs=1.63,1.57,and 1.89）.In cohort studies,sleep problems could predict suicidal ideation,suicide plan,and suicide attempt（pooled ORs=1.35,2.40,and 1.61）.Subgroup analysis in cohort study showed that controlled depression sleep problems were still associated with suicidebehaviors,and sleep problems had a stronger predictive effect（OR=2.30,95% CI:1.09-2.41,P <0.001）.In addition,the ability of sleep problems to predict suicide attempt was affected by the change of follow-up duration,and the prediction effect of follow-up duration;2 years was stronger（pooled ORs=2.43 vs.1.19,P <0.01）.Conclusion:Sleep problems could increase the suicide risk in adolescents. [ABSTRACT FROM AUTHOR]

BackgroundEpidemiological data have demonstrated seasonal and circadian patterns of suicidal deaths. Several reviews and meta-analyses have confirmed the relationship between sleep disturbance and suicidality. However, these reviews/meta-analyses have not focused on seasonal and circadian dysfunction in relation to suicidality, despite the common presence of this dysfunction in patients with mood disorders. Thus, the current literature review analyzed studies investigating person-specific chronotype, seasonality, and rhythmicity in relation to suicidal thoughts and behaviors.MethodsStudy authors reviewed articles related to individual-level chronotype, seasonality, and rhythmicity and suicidality that were written in English and not case reports or reviews.ResultsThis review supports a relationship between an eveningness chronotype, greater seasonality, and decreased rhythmicity with suicidal thoughts and behaviors in those with unipolar depression, as well as in other psychiatric disorders and in children/adolescents.LimitationsThese findings need to be explored more fully in mood disordered populations and other psychiatric populations, in both adults and children, with objective measurement such as actigraphy, and with chronotype, seasonality, and rhythmicity as well as broader sleep disturbance measurement all included so the construct(s) most strongly linked to suicidality can be best identified.ConclusionsEveningness, greater seasonality, and less rhythmicity should be considered in individuals who may be at risk for suicidal thoughts and behaviors and may be helpful in further tailoring assessment and treatment to improve patient outcome.

Background: Suicide is a severe public health problem, resulting in a high number of attempts and deaths each year. Early detection of suicidal thoughts and behaviors (STBs) is key to preventing attempts. We discuss passive sensing of digital and behavioral markers to enhance the detection and prediction of STBs. Objective: The paper presents the protocol for a systematic review that aims to summarize existing research on passive sensing of STBs and evaluate whether the STB prediction can be improved using passive sensing compared to prior prediction models. Methods: A systematic search will be conducted in the scientific databases MEDLINE, PubMed, Embase, PsycINFO, and Web of Science. Eligible studies need to investigate any passive sensor data from smartphones or wearables to predict STBs. The predictive value of passive sensing will be the primary outcome. The practical implications and feasibility of the studies will be considered as secondary outcomes. Study quality will be assessed using the Prediction Model Risk of Bias Assessment Tool (PROBAST). If studies are sufficiently homogenous, we will conduct a meta-analysis of the predictive value of passive sensing on STBs. Results: The review process started in July 2022 with data extraction in September 2022. Results are expected in December 2022. Conclusions: Despite intensive research efforts, the ability to predict STBs is little better than chance. This systematic review will contribute to our understanding of the potential of passive sensing to improve STB prediction. Future research will be stimulated since gaps in the current literature will be identified and promising next steps toward clinical implementation will be outlined. [ABSTRACT FROM AUTHOR]

Previous research supports a link between school-related factors, such as bullying and school connectedness, and suicidal thoughts and behaviors. To deepen understanding of how school experiences may function as both protective and risk factors for youth struggling with suicidal thoughts and behaviors, this qualitative study explored multiple perspectives. Specifically, in-depth interviews were conducted with adolescents previously hospitalized for a suicidal crisis (n = 19), their parents (n = 19), and the professionals they may interact with in schools and hospitals (i.e., school professionals [ n = 19] and hospital providers [ n = 7]). Data were analyzed using applied thematic analysis revealing three main themes related to perceptions of how school experiences can positively or negatively impact mental health, including (a) school activities, (b) school social experiences, and (c) school interventions. An emergent theme related to the complexity of suicide-related risk identified the ways in which school experiences may intersect with other environmental, biological, and psychological factors. Findings underscore the need for school-based approaches to address the unique academic, social, and emotional needs of students with suicide-related risk that complement the supports and services provided in their home and community. [ABSTRACT FROM AUTHOR]

• It is feasible and acceptable to use EMA to assess suicidality among young people with mood disorder in the Chinese cultural and social context. • Despite decreased adherence over time, participants reported an overall positive experience with the EMA study (e.g., helpful, friendly, and acceptable). However, a small proportion of participants had negative experiences (e.g., annoyance and missing prompts). • Future EMA studies should consider the frequency of surveys, the burden perceived by individuals, and individual differences when designing the EMA protocol. Suicidal thoughts and behaviors (STBs) are increasing among young people (aged 12–24 years) in China. Although Ecological Momentary Assessment (EMA) has been increasingly used to study STBs worldwide, no study has been conducted on young people with mood disorders (MD) in China. This mixed-method study aimed to evaluate the feasibility and acceptability of suicide risk monitoring in 75 young people with MD. Participants completed five to eight daily EMA surveys and wore smart bands for the EMA study. Semi-structured interviews were used to collect feedback. High adherence to EMA surveys (73.0 %) and smart bands (87.4 %) indicated feasibility. Participants reported an overall positive experience with the EMA study (helpful, friendly, and acceptable). Additionally, the reasons they were willing to comply with the EMA study were: (1) seeing the possibility of returning to "normal," and (2) experiencing the process of returning. However, a small proportion of participants had negative experiences (e.g., annoyance and missing prompts). The results of this mixed-methods study provide preliminary support for the feasibility and acceptability of using EMA (combined smartphones and wearable sensor devices) to assess suicidality among young people with MD in the Chinese cultural and social context. [ABSTRACT FROM AUTHOR]

Although perceived and internalized suicide stigma are considered risk factors for suicidal thoughts and behaviors (STBs), their specific roles in STBs are not well understood. This study examined the relationships among perceived and internalized suicide stigma, hopelessness, unbearable pain, suicidal desire, and suicide attempts in college students. A total of 1,387 Chinese college students (mean age: 22.22 years) completed the relevant scales. Structural equation modeling was used to determine the relationships of interest. The results showed that perceived stigma primarily had indirect impacts on suicidal desire through internalized stigma, which subsequently affected unbearable pain and hopelessness. The findings of this study suggest that the internalization of suicide stigma is an important predictor of STBs. These findings advocate for stigma interventions aimed at reducing internalized stigma as a potentially effective strategy for suicide prevention, as it may alleviate unbearable pain and hopelessness, which are significant contributors to suicidal desire and attempts. [ABSTRACT FROM AUTHOR]

Support from parents and school staff are important for adolescent well-being. However, few studies have examined the role of parental involvement and adult social support at school on high school students' mental health, specifically, suicidal thoughts and behaviors (STBs). Data were collected from 362,980 high school students (51.85% female) from 412 schools in Georgia. Students reported perceptions of parental involvement, adult social support at school, experiences of face-to-face victimization, cyber victimization, and STBs. Hierarchical linear modeling (HLM) results showed that perceived parental involvement and adult social support at the student and school levels were negatively related to adolescent STBs. Face-to-face victimization and cyber victimization at the student and school levels were significant predictors for STBs. Student-level perceived parental involvement and adult social support mitigated the relationship between peer victimization and STBs. However, school-level perceived adult social support exacerbated the relationship between face-to-face and cyber victimization and STBs. It is essential to attend to the differential effect of student-level and school-level adult social support on youth mental health. It is also important to promote parental involvement and adult social support to promote mental health among high school students. Impact and Implications This study highlights the risk of both face-to-face and cyber victimization and the protective role of parental involvement on adolescent suicide. It also differentiates the effect of student-level and school-level adult social support for youth who experience peer victimization. [ABSTRACT FROM AUTHOR]

Introduction Suicidal thoughts and behaviors (STB) are a serious public health problem. Suicide prevention programs have been established over the years but many people who are suicidal do not seek treatment, and when they do they will end up in low-threshold sectors such as the Emergency Department in general hospitals. Previous studies about STB are mostly narrative, rather than a date-driven approach and limited in sample size. Objectives The main goal of this study is to describe the prevalence and evolution of STB (ideation, plan or attempt) of the psychiatric patient referred to the Emergency Department of the University Hospital Gasthuisberg (Leuven, Belgium) over a 12 year period. Methods During a 12 year period (2003-2015), all patients with a psychiatric referral to the Psychiatric Emergency Room (PER) of the University Hospital Gasthuisberg (Leuven, Belgium) were included (N˜25.000). We use descriptive statistics to summarize the data set, focusing on STB in terms of raw numbers, symptoms at referral, mental disorders and demographic characteristics. Results Around 1/9 patients presents with suicide attempt; another 1/5 with suicidal thoughts. STB accounts for 35% of psychiatric primary complaints at the PER. Women were more likely to present with STB. The proportion of STB referrals remains stable over the years. Conclusions Despite several reforms in mental health care, the PER remains a major entry point into mental healthcare for large proportions of STB patients. Disclosure No significant relationships.

Background: Suicidal thoughts and behaviors (STBs) among adolescents have hardly decreased despite preventative efforts. School-based prevention programs could have a great reach, yet suicide prevention is not an easy topic to address. To increase acceptability of school-based suicide prevention, it is important to evaluate whether programs that target known risk factors of STBs, such as depression, could be equally effective.Methods: We conducted a systematic literature search in major electronic databases. Outcomes were suicidal ideation and behaviors. Multivariate random effects meta-regression-analyses were conducted.Results: Eleven primary studies met the inclusion criteria, totalling 23,230 participants. The post-test effect size was small for both suicidal ideation (g = 0.15) and suicidal behaviors (g = 0.30). Meta-regression indicated that targeting known risk factors of STBs was not a significant modifier of effect size for ideation, indicating equal effectiveness. However, it was significant modifier of effect for behaviors, but only one intervention targeted know risk factors. Effects at follow-up (3-12 months) were also significant but small for both outcomes.Limitations: Substantial heterogeneity between studies was noted. Only few and small sample size studies could be included that targeted known risk factors of STBs. Therefore, these results should be interpreted with caution.Conclusions: School-based prevention of STBs shows some promise within three months post-test assessments, and potentially also have effects that are sustained over time. More studies are needed to make conclusions regarding school-based interventions that target risk factors of STBs. [ABSTRACT FROM AUTHOR]

Rates of youth suicidal thoughts and behaviors (STBs) are rising, and younger age at onset increases vulnerability to negative outcomes. However, few studies have investigated STBs in early adolescence (ages 10-13), and accurate prediction of youth STBs remains poor. Network analyses that can examine pairwise associations between many theoretically relevant variables may identify complex pathways of risk for early adolescent STBs. The present study applied longitudinal network analysis to examine interrelations between STBs and several previously identified risk and protective factors. Data came from 9,854 youth in the Adolescent Brain Cognitive Development Study cohort ( M age = 9.90 ± .62 years, 63% white, 53% female at baseline). Youth and their caregivers completed an annual measurement battery between ages 9-10 through 11-12 years. Panel Graphical Vector Autoregressive models evaluated associations between STBs and several mental health symptoms, socioenvironmental factors, life stressors, and substance use. In the contemporaneous and between-subjects networks, direct associations were observed between STBs and internalizing symptoms, substance use, family conflict, lower parental monitoring, and lower school protective factors. Potential indirect pathways of risk for STBs were also observed. Age-specific interventions may benefit from prioritizing internalizing symptoms and early substance use, as well as promoting positive school and family support.

Background: Men are up to four times more likely to die by suicide than women. At the same time, men are less likely to disclose suicidal ideation and transition more rapidly from ideation to attempt. Recently, socialized gender norms and particularly conformity to masculine norms (CMN) have been discussed as driving factors for men's increased risk for suicidal thoughts and behaviors (STBs). This study aims to examine the individual interplay between CMN dimensions and their association with depression symptoms, help-seeking, and STBs., Methods: Using data from an anonymous online survey of 488 cisgender men, latent profile analysis was performed to identify CMN subgroups. Multigroup comparisons and hierarchical regression analyses were used to estimate differences in sociodemographic characteristics, depression symptoms, psychotherapy use, and STBs., Results: Three latent CMN subgroups were identified: Egalitarians (58.6 %; characterized by overall low CMN), Players (16.0 %; characterized by patriarchal beliefs, endorsement of sexual promiscuity, and heterosexual self-presentation), and Stoics (25.4 %; characterized by restrictive emotionality, self-reliance, and engagement in risky behavior). Stoics showed a 2.32 times higher risk for a lifetime suicide attempt, younger age, stronger somatization of depression symptoms, and stronger unbearability beliefs., Conclusion: The interplay between the CMN dimensions restrictive emotionality, self-reliance, and willingness to engage in risky behavior, paired with suicidal beliefs about the unbearability of emotional pain, may create a suicidogenic psychosocial system. Acknowledging this high-risk subgroup of men conforming to restrictive masculine norms may aid the development of tailored intervention programs, ultimately mitigating the risk for a suicide attempt., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2024 The Authors.)

Purposes: To better assess and reduce suicidal risk in first-episode psychosis (FEP), we aimed to investigate the evolution of suicidal thoughts and behaviors (STBs) and associated factors in FEP.Method: This systematic review (PROSPERO-CRD42020168050) meets PRISMA guidelines. PubMed, Medline, PsycINFO, Embase, EBM Reviews and references lists of relevant articles were searched (February 2020) to identify longitudinal studies, published in English or in French, that assessed the prevalence of STBs at entry to services and over follow-up, and examined factors associated with STBs among all persons with affective and non-affective FEP from a defined catchment area. Screening, data extraction and quality assessment using the adapted Newcastle Ottawa Scale were done independently by two reviewers. Results on prevalence and associated factors are presented by type of STB.Results: Of 3,177 references, 17 studies of 11 non-overlapping samples (n = 14,907) with varying lengths of follow-up (1-41.7 years) were included. The prevalence of STBs decreased over follow-up. Up to 21.6% made at least one suicide attempt, 27% had suicidal ideation, and 1-4.3% died by suicide during follow-up. Of 53 factors assessed across studies, only male sex, depressive symptoms, and STBs occurring early during follow-up were associated with subsequent STBs. Early intervention for psychosis decreased STBs in the first three years. Other factors were assessed in a single study, yielded conflicting results, or were not associated with STBs.Conclusions: The high prevalence of STBs following onset of psychosis highlights the need for early detection and intervention and ongoing assessment of suicidal risk throughout follow-up, with attention to identified risk factors. The heterogeneity of the studies precluded a meta-analysis and several factors were each assessed by a single study. Additional well-designed longitudinal studies of STBs and associated factors are warranted. [ABSTRACT FROM AUTHOR]

Suicidal ideation, suicide attempt (SA) and suicide are significantly heritable phenotypes. However, the extent to which these phenotypes share genetic architecture is unclear. This question is of great relevance to determining key risk factors for suicide, and to alleviate the societal burden of suicidal thoughts and behaviors (STBs). To help address the question of heterogeneity, consortia efforts have recently shifted from a focus on suicide within the context of major psychopathology (e.g. major depressive disorder, schizophrenia) to suicide as an independent entity. Recent molecular studies of suicide risk by members of the Psychiatric Genomics Consortium and the International Suicide Genetics Consortium have identified genome-wide significant loci associated with SA and with suicide death, and have examined these phenotypes within and outside of the context of major psychopathology. This review summarizes important insights from epidemiological and biometrical research on suicide, and discusses key empirical findings from molecular genetic examinations of STBs. Polygenic risk scores for these phenotypes have been observed to be associated with case−control status and other risk phenotypes. In addition, estimated shared genetic covariance with other phenotypes suggests specific medical and psychiatric risks beyond major depressive disorder. Broadly, molecular studies suggest a complexity of suicide etiology that cannot simply be accounted for by depression. Discussion of the state of suicide genetics, a growing field, also includes important ethical and clinical implications of studying the genetic risk of suicide. [ABSTRACT FROM AUTHOR]

Individuals experiencing suicidal thoughts and behaviors (STBs) show less specificity and positivity during episodic future thinking (EFT). Here, we present findings from two studies aiming to (1) further our understanding of how STBs may relate to neural responsivity during EFT and (2) examine the feasibility of modulating EFT-related activation using real-time fMRI neurofeedback (rtfMRI-nf). Study 1 involved 30 individuals with major depressive disorder (MDD; half with STBs) who performed an EFT task during fMRI, for which they imagined personally-relevant future positive, negative, or neutral events. Positive EFT elicited greater ventromedial prefrontal cortex (vmPFC) activation compared to negative EFT. Importantly, the MDD + STB group exhibited reduced vmPFC activation across all EFT conditions compared to MDD-STB; although EFT fluency and subjective experience remained consistent across groups. Study 2 included rtfMRI-nf focused on vmPFC modulation during positive EFT for six participants with MDD + STBs. Results support the feasibility and acceptability of the rtfMRI-nf protocol and quantitative and qualitative observations are provided to help inform future, larger studies aiming to examine similar neurofeedback protocols. Results implicate vmPFC blunting as a promising treatment target for MDD + STBs and suggest rtfMRI-nf as one potential technique to explore for enhancing vmPFC engagement. • Greater vmPFC activation is observed for positive versus negative future thinking. • Suicidal thoughts and behaviors relate to vmPFC blunting during future thinking. • Real-time fMRI neurofeedback of the vmPFC is feasible and acceptable. [ABSTRACT FROM AUTHOR]

Abstract: Emotion dysregulation is associated with increased risk for suicidal thoughts and behaviors (STBs) and nonsuicidal self-injury (NSSI). However, research in this area has focused almost exclusively on dysregulation stemming from negative emotions. The present study aimed to address this gap in the literature by examining the associations between the specific domains of positive emotion dysregulation and both STBs and NSSI. Participants included 397 trauma-exposed community adults (Mage = 35.95; 57.7% female; 76.8% White). Results demonstrated significant associations between positive emotion dysregulation and both STBs and NSSI. In particular, higher levels of nonacceptance of positive emotions were found to be significantly related to risk for STBs (versus no risk), higher severity of STBs, and history of NSSI (versus no history). Findings suggest positive emotion dysregulation may play an important role in the etiology and treatment of both STBs and NSSI among trauma-exposed individuals. [ABSTRACT FROM AUTHOR]

Background: Healthcare workers are a key occupational group at risk for suicidal thoughts and behaviors (STB). We investigated the prevalence and correlates of STB among hospital workers during the first wave of the Spain COVID‐19 outbreak (March–July 2020). Methods: Data come from the baseline assessment of a cohort of Spanish hospital workers (n = 5450), recruited from 10 hospitals just after the height of the coronavirus disease 2019 (COVID‐19) outbreak (May 5–July 23, 2020). Web‐based self‐report surveys assessed 30‐day STB, individual characteristics, and potentially modifiable contextual factors related to hospital workers' work and financial situation. Results: Thirty‐day STB prevalence was estimated at 8.4% (4.9% passive ideation only, 3.5% active ideation with or without a plan or attempt). A total of n = 6 professionals attempted suicide in the past 30 days. In adjusted models, 30‐day STB remained significantly associated with pre‐pandemic lifetime mood (odds ratio [OR] = 2.92) and anxiety disorder (OR = 1.90). Significant modifiable factors included a perceived lack of coordination, communication, personnel, or supervision at work (population‐attributable risk proportion [PARP] = 50.5%), and financial stress (PARP = 44.1%). Conclusions and Relevance: Thirty‐day STB among hospital workers during the first wave of the Spain COVID‐19 outbreak was high. Hospital preparedness for virus outbreaks should be increased, and strong governmental policy response is needed to increase financial security among hospital workers. [ABSTRACT FROM AUTHOR]

Introduction Suicide is the third leading cause of death in adolescents (15-19 years). Physical pain is an important risk factor for suicidal thoughts and behaviors, especially in a delicate phase as adolescence. Objectives Several studies investigated this association and the aim of this meta-analysis was to synthesize data in literature about this topic in adolescents (11-20 years). Methods We started from a systematic review published by Hinze and colleagues in 2019 and we searched on PubMed (January 2019-June 2020) studies comparing rates of suicidal outcomes (Suicidal Ideation, Suicide Plan, Attempt, Self-Harm: SI, SP, SA, SH) in individuals with any type of physical pain (head, back, neck, chest, stomach, abdomen, muscle, joint, arthritis) vs. those without it. Data were analyzed with Comprehensive Meta-Analysis software (CMA, version 3). Results Of the 16 included studies, eleven focused on SI (68.8%), six (37.5%) on SA, four (25%) on SH and two (12.5%) on SP. Adolescents with physical pain were more likely to report SI (p < .001), SH (p < .001), SA (p = .004) and SP (p = .006). In all analyses, the between study heterogeneity was high. The presence of publication bias has been detected in SI (k≥10). Conclusions Results are in line with previous literature on this topic. Future research should investigate the specific impact of: acute vs. chronic pain; different types and intensities of pain; planned vs. impulsive action and therefore suicidal intent; role of psychological factors (in particular sensitivity and tolerance to physical pain).

Previous studies have shown that suicide-bereaved individuals may suffer increased risk of suicidal thoughts and behaviors (STBs) due to traumatic grief. In this paper, we present the self-reported rate of STB among Swedish suicide-bereaved women (N = 293). Data was collected in a cross-sectional anonymous survey on the homepages of Sweden’s leading suicide survivor organization, SPES. We used logistic regression to evaluate risks (of any STB event) related to losing a child compared to other relatives and the experience of social avoidance from family members, as well as feelings of shame and guilt. The self-reported rate of suicidal thoughts, plans, and attempts was 60, 24, and 5 percent, respectively, considerably higher than in the general population. Results showed that all of the investigated variables were independent risk factors for STB (ORs ranged between 1.29 and 2.69). Women who had both lost a child and experienced family avoidance reported the highest STB rate (87.5%), and we found an interaction effect between these two risk factors (OR = 3.45; 95% CI = 1.05–11.32) that was related to self-reported shame. It is concluded that perceived responsibility for someone else’s suicide, and the social avoidance associated with it, may play an important role for suicide survivors and should be targeted by postvention activities.

Suicide deaths in people with non-affective psychosis represent a major health care concern. Previous research has shown that psychosis and the associated distress increase suicidal experiences, whereas psychological resilience weakens the impact of suicide precursors, such as defeat, entrapment, and hopelessness on suicidal experiences. The moderating roles of psychosis, distress, and psychological resilience in the relationships between defeat, entrapment, hopelessness, and suicidal thoughts and behaviors have not been tested longitudinally. This 3-month longitudinal study used moderated mediation analysis to investigate: (1) the impact of defeat/entrapment and hopelessness on suicidal thoughts and behaviors and (2) the moderating effects of psychosis, distress, and psychological resilience in the relationships between defeat/entrapment, hopelessness, and suicidal thoughts and behaviors. Individuals with non-affective psychosis-related diagnosis (including schizophrenia, schizophreniform disorder, schizoaffective disorder, delusional disorder, or psychotic disorders not otherwise specified) and lifetime experiences of suicidal thoughts, plans, and/or acts were recruited from the NorthWest of England, UK. Of the 100 participants at baseline, 90 took part in the follow-up assessment. At baseline, most of the participants had experienced one or more lifetime suicide attempts. Suicidal thoughts and behaviors scores were significantly lower at follow-up, compared with baseline. Over time, defeat/entrapment predicted suicidal thoughts and behaviors when the severity of psychosis and the associated distress were moderate and high, and resilience was lowest. The impact of defeat/entrapment, psychosis, distress due to psychosis, and resilience needs to be incorporated into interventions aiming to reduce suicidal experiences. These findings impact psychosis and resilience-focused suicide prevention interventions for people with non-affective psychosis. [ABSTRACT FROM AUTHOR]

Understanding the cognitive and emotional mechanisms that link autistic traits and risk for suicide is a vital next step for research and clinical practice. This study included a broad sample of adult women (n = 74) who report finding social situations confusing and/or exhausting, and who score high on measures of autistic traits. Regardless of autism diagnostic status, these women reported high rates of suicidal thoughts and behaviors. Depression symptoms were more associated with suicidality than were autistic trait measures of social communication. Measures of neurotypical "imagination" and of repetitive behavior likewise were associated with suicidality risk. Simultaneously feeling sad and feeling stuck or unable to imagine alternate strategies, may uniquely increase suicide risk in autism. [ABSTRACT FROM AUTHOR]

Previous studies have shown that suicide-bereaved individuals may suffer increased risk of suicidal thoughts and behaviors (STBs) due to traumatic grief. In this paper, we present the self-reported rate of STB among Swedish suicide-bereaved women (N = 293). Data was collected in a cross-sectional anonymous survey on the homepages of Sweden's leading suicide survivor organization, SPES. We used logistic regression to evaluate risks (of any STB event) related to losing a child compared to other relatives and the experience of social avoidance from family members, as well as feelings of shame and guilt. The self-reported rate of suicidal thoughts, plans, and attempts was 60, 24, and 5 percent, respectively, considerably higher than in the general population. Results showed that all of the investigated variables were independent risk factors for STB (ORs ranged between 1.29 and 2.69). Women who had both lost a child and experienced family avoidance reported the highest STB rate (87.5%), and we found an interaction effect between these two risk factors (OR = 3.45; 95% CI = 1.05–11.32) that was related to self-reported shame. It is concluded that perceived responsibility for someone else's suicide, and the social avoidance associated with it, may play an important role for suicide survivors and should be targeted by postvention activities. [ABSTRACT FROM AUTHOR]

Purpose Of Review: To review and discuss recent advances in evidence-based interventions (EBIs) for youth suicide risk.Recent Findings: There is a growing body of research on the effectiveness of interventions targeting suicidal ideation and behavior among adolescents. Dialectical Behavioral Therapy-Adolescent has shown effectiveness across two independent randomized controlled trials (RCTs). Several other interventions have shown effectiveness in only one trial and are in need of replication. New interventions are also being developed that incorporate developments in technology and adaptive intervention designs. It is recommended that future research focus on strategies for engaging underserved youth with interventions, consider the broader needs of youth living in poverty, and further tailor interventions to subgroups with distinct risk profiles. Limited EBIs exist for preadolescents, despite evidence for an increasing rate of suicidal behavior for these youth. Several interventions for youth suicide risk are highly promising, but further investigation is necessary. EBIs that are effective for preadolescents are needed, and greater efforts to tailor interventions for distinct subgroups of youth at risk are recommended. [ABSTRACT FROM AUTHOR]

• 3 % of youth experienced homelessness during the past 30 days. • 21.3 % of youth experienced suicidal ideation and 10.9 % attempted suicide. • Sexual minority youth had almost doubled the odds of experiencing homelessness. • Non-Hispanic Black youth had 2.58 times higher odds of experiencing homelessness. • Experiencing homelessness was associated with suicidal ideation, planning, and attempt. Although various studies have examined factors associated with suicidal behaviors among youth, few studies have investigated the association between youth experiencing homelessness (YEH) and suicidal thoughts and behaviors (STBs) using a large nationally representative sample. The objectives of this study were to investigate prevalence of YEH and its association with STBs. Data for this study came from the 2021 Youth Risk Behavior Survey. An analytic sample of 17,033 youth aged 14–18 (51.7 % male) was analyzed using binary logistic regression. Of the 17,033 youth examined, 3 % experienced homelessness during the past 30 days, 21.3 % experienced suicidal ideation, 17.3 % made a suicide plan, and 10.9 % attempted suicide during the past 12 months. Controlling for demographic characteristics and feeling sad or hopeless, YEH was associated with 2.48 times higher odds of experiencing suicidal ideation (AOR =2.48, p <.001), 2.46 times higher odds of making a suicide plan (AOR =2.46, p <.001), and 4.38 times higher odds of making a suicide attempt (AOR =4.38, p <.001). The findings of this study highlight the importance of identifying youth who are at risk of experiencing homelessness to ensure early interventions are put in place to prevent suicidal behaviors. [ABSTRACT FROM AUTHOR]

• Suicidal thoughts and behaviors remain understudied in OCD. • Examined implicit and explicit suicidality in adults receiving treatment for OCD. • 77 % reported lifetime suicidal thoughts; 16 % reported prior suicide attempt. • OCD severity was higher for those with lifetime suicidal thoughts and prior attempts. • Implicit biases towards death did not predict explicitly endorsed suicidality. Obsessive-compulsive and related disorders (OCRDs) are associated with increased risk of suicidal thoughts and behaviors (STBs), yet research characterizing suicidality in OCRDs remains limited. A major challenge in assessing STBs is the reliance on explicit self-report. This study utilized multi-method assessment to examine changes in both implicit and explicit STBs in 31 adults receiving partial/residential treatment for OCRDs. Assessments were administered at admission and weekly during treatment. Approximately three-quarters of participants reported lifetime suicidal thoughts, with 16 % reporting a prior suicide attempt. OCD severity was significantly correlated with lifetime suicidal thoughts, and was significantly higher for those with lifetime suicidal thoughts and prior attempts compared to those without. Implicit biases towards death were not associated with OCD severity, and did not predict explicitly endorsed STBs. This is the first study to measure both explicit and implicit STBs in adults with OCRDs. Limitations included small sample size and lack of racial/ethnic diversity. Given the majority had recent suicidal thoughts and one in six had a prior attempt, we emphasize the importance of STB assessment in OCD treatment settings. [ABSTRACT FROM AUTHOR]