Search

AbstractBackgroundObjectiveMethodsResultsConclusionsFew studies to date have examined the number of comorbid substances used alongside Prescription Opioid Misuse (POM) to predict suicidal behaviors among US young adults.This study investigated the relationship between comorbid substance use with POM and suicidal behaviors among the US young adults.Data were from individuals aged 18–25 (N = 69,204, 51.8% female) in the 2015–2019 National Surveys on Drug Use and Health (NSDUH). The final analytic sample for logistic regression was 36,892 young adults.After controlling for key covariates, the combination of POM and three or more illicit drugs were at the greatest odds of suicidal ideation (OR = 2.57, 95% CI = 1.61 − 4.11, p < 0.001) and attempts (OR = 3.57, 95% CI = 1.89 − 6.76, p < 0.001) compared to those without POM or drug use.The study provides evidence of a dose-response relationship between the number of illicit drugs uses alongside POM and the suicide risk as a clinically important phenomenon with implication for intervention. Findings highlight that POM, with or without illicit drug use, can serve as a behavioral and clinical indicator for identifying young adults at heightened risk of suicidality. This group warrants prioritized intervention targets to ensure timely access to developmentally appropriate clinical treatment, aiming to mitigate addiction progression and prevent harm and mortality. [ABSTRACT FROM AUTHOR]

Introduction: Research has largely conceptualized suicidal ambivalence as the difference between one's wish to live and wish to die without fully considering other suicide ideation (SI) experiences included on measures like the Beck Scale for Suicide Ideation (BSS). We utilized BSS items to identify SI latent classes and examined relevant correlates and outcomes. Methods: We collected self‐report data from two samples of US adults who: (1) self‐identified as LGBTQ+ (N = 349; cross‐sectional) and (2) self‐reported past‐week SI (BSS score ≥ 11; N = 133; 3 timepoints). Results: Latent class analyses supported three‐class (Sample 1) and four‐class solutions (Sample 2), which included ambivalent classes. In Sample 1, sexual orientation, gender, depression, anxiety, SI, and suicide‐specific rumination were concurrently associated with class membership. In Sample 2, depression, SI, suicide‐specific rumination, and physical/psychological distance from suicide methods were concurrently associated with class membership. In Sample 2, at both follow‐ups, suicide plans/preparations and Acute Suicidal Affective Disturbance symptom frequencies were provided by class membership, and suicidal intent significantly differed by class membership. Conclusions: SI classes differed by sample and evidenced nuances in SI and suicidal ambivalence. Risk factors and suicide‐related outcomes also differed by class membership. Implications and limitations are discussed. [ABSTRACT FROM AUTHOR]

Understanding the mechanisms of suicidal behavior is a prerequisite for suicide prevention and intervention. The current study aims to propose and verify the utility of pre-suicidal attempt as an intermediate type in the transition from suicidal ideation to suicidal attempt within the ideation-to-action framework. A sample of 1084 college students completed a measurement package consisting of suicide history, suicide risk factors, and demographic information. Stratified stepwise multiple regression models and mediated moderation models were used to examine the relationship among the variables. Pre-suicidal attempts rather than suicidal ideation are predictive of suicide attempts. Age, depression, thwarted belongingness, fearlessness about death, perceived burdensomeness and suicidal ideation were predictors of pre-suicidal attempts. Supporting the interpersonal theory of suicide, pre-suicidal attempts mediated the relationship between suicidal ideation and suicidal attempts and were positively moderated by pain tolerance and fearlessness about death. The pre-suicidal attempters scored higher on fearlessness about death and suicide risk than the ideators, while pre-suicidal attempters scored significantly lower on suicide risk than suicide attempters. As an independent intermediate type within the ideation-to-action framework, pre-suicidal attempts contribute to deepen the understanding of the intermediate transition from suicidal ideation to suicidal attempts. • We propose a novel "pre-suicidal attempt" to cover the series of preparatory actions that precede a suicidal attempt. • Depression, thwarted belongingness, fearlessness about death, perceived burdensomeness and suicidal ideation were predictors of pre-suicidal attempts. • Pre-suicidal attempts mediated the relationship between suicidal ideation and suicidal attempts and were positively moderated by pain tolerance and fearlessness about death. • The pre-suicidal attempters scored higher on fearlessness about death and suicide risk than the ideators, while pre-suicidal attempters scored significantly lower in suicide risk than suicide attempters. • Pre-suicidal attempts focus on the ambiguous areas of the Ideation-to-action framework, helping to provide insight into the mechanisms of transition from suicidal ideation to suicidal behavior and contributing to the development of the framework. [ABSTRACT FROM AUTHOR]

HIV-positive men who have sex with men (MSM) are at high risk of suicide and experience intersectional inequalities. The Social Determinants of Health (SDH) framework provides valuable insights into how inequalities can lead to adverse outcomes. This study aimed to employ the SDH framework to identify factors that contribute to suicidal behaviors among this population. 1410 HIV-positive MSM were recruited using a web-based questionnaire, whose mean age was 30.77 ± 6.92 years old. Participants completed questionnaires including baseline information and psychological measurements, such as Suicidal Behaviors Questionnaire-Revised (SBQ-R). Logistic regression analysis was conducted to screen for risk factors associated with suicidal behaviors. More than half of the participants (53.3 %, 752/1410) had an SBQ score of 7 or higher. Binary logistic regression analysis of structural and intermediary determinants (Model 3) revealed that sexual orientation, stigma (ORs: 1.018, 95 % CI: 1.005–1.032), interpersonal needs (ORs: 1.021, 95 % CI: 1.010–1.031), depression (ORs: 1.037, 95 % CI: 1.001–1.074) and entrapment (ORs: 1.018, 95 % CI: 1.004–1.032) were positively correlated with suicidal behaviors. Individuals with other or unknown sexual orientation had significantly higher rates of suicidal behaviors compared to those with a heterosexual sexual orientation (ORs: 5.021, 95 % CI: 1.529–17.640). Sampling of HIV-positive MSM posed challenges in data collection. It may introduce selection bias and affect generalizability. This study identified that sexual orientation, stigma, interpersonal needs, depression, and entrapment were significantly associated with suicidal behaviors among HIV-positive MSM. Additionally, these factors can be social determinants of health that contribute to suicidal behaviors. • This study is the first to apply the SDH framework in HIV-positive MSM. • SBQ scale rather than one or a few questions was used to measure the suicidal behaviors among HIV-positive MSM. • Sexual orientation, stigma, interpersonal needs, depression, entrapment contribute to suicidal behaviors in HIV-positive MSM. [ABSTRACT FROM AUTHOR]

Food insecurity is a risk factor for poor mental health and suicidal behaviors among adolescents. Prior research shows that states with policies that expand Supplemental Nutrition Assistance Program (SNAP) eligibility have a lower prevalence of food insecurity. The primary aim of this study was to compare the prevalence of feelings of sadness or hopelessness, suicidal ideation, and suicide attempts among adolescents in states that had the asset test eliminated and the income limit increased for SNAP eligibility to adolescents in states that did not have either policy. Using 2013-2021 data from state Youth Risk Behavior Surveys (N = 855,119) and the SNAP Policy Database, we conducted log-binomial regression with generalized estimating equations and adjusted for confounders. The prevalence of persistent feelings of sadness or hopelessness was similar among adolescents in states that had the asset test eliminated only and among adolescents in states that had both the asset test eliminated and the income limit increased (i.e., both policies) compared to adolescents in states that did not have either policy. While the prevalence of suicidal thoughts was similar among adolescents in states that had the asset test eliminated only compared to adolescents in states that did not have either policy, the prevalence of suicidal thoughts (prevalence ratio = 0.91, 95% CI 0.88, 0.94) and suicide attempts (prevalence ratio = 0.82, 95% CI 0.78, 0.86) was lower among adolescents in states that had both policies compared to adolescents in states that did not have either policy. States with policies that expand SNAP eligibility have a lower prevalence of suicidal behaviors among adolescents. [ABSTRACT FROM AUTHOR]

Abstract Background This paper examines the frequency of suicidal behaviors (suicidal ideation or attempt) among a sample of Syrian refugee women living in non-camp settings in Jordan. We asked several questions surrounding suicide and examined the associations between post-traumatic stress disorder (PTSD), social connectedness, post-displacement stressors and suicidal behaviors. Methods Participants (n = 507) were recruited using a clinic-based systematic sampling from four health clinics throughout Jordan in 2018. We used a multivariable logistic regression to examine the hypothesis of whether positive screening for PTSD (PCL-5), social isolation (have no friends or family members available to help), and greater number of post-displacement stressors (PMLD Checklist) is associated with suicidal behaviors. Results Approximately one-tenth (9.86%) of participants surveyed reported suicidal behaviors (suicidal ideation or attempt) in the past six months. Our hypothesis was partially supported. In the adjusted multivariable analyses, screening positive for PTSD [OR:4.02 (95% CI:1.33, 12.15)] increased odds of suicidal behaviors, while having one friend or family member available to help when in need [OR:0.31 (95% CI:0.13, 0.78)] decreased odds of suicidal behaviors. We did not find any associations between the number of post-displacement stressors and suicidal behaviors in the multivariable model. Conclusion Agencies and practitioners addressing suicidal behaviors among Syrian refugee women should provide interventions that aim to reduce PTSD symptoms and social isolation. Potential intervention includes screening for mental health symptoms and suicidal behaviors during routine visits with service providers, as well as providing proper mental health and psychosocial support services according to the mapping of available services.

Suicidality poses a significant public health threat and stands as a leading cause of death and disability. Aside from committed suicides, a substantial portion of suicidal behaviors comprises suicide attempts and suicidal ideation. These events may be characterized by a non-fatal outcome, shedding light on the possibility of recurrence. The objectives of the present study were to assess hospitalization rate trends related to any suicidal event and to elucidate the risk factors associated with recurrent suicidal behaviors. In this population-based study, an observational descriptive analysis was conducted on all hospital discharge forms (HDRs, Italian SDO) registered for the residents of the Veneto Region from 2012 to 2021. Cases of attempted suicide (AS) and suicidal ideation (SI) were defined according to ICD coding. Age-standardized hospitalization rates were computed with the direct method. Join Point Regression was used to assess the significance of variations in trends. Factor risks for the reiteration of suicidal behaviors were assessed by multivariate logistic regression. Higher prevalence of SI occurred among individuals under 40 years of age and those affected by psychiatric disorders. Conversely, among individuals aged 60 and above, AS was more common. SI turned out to be associated with a higher likelihood of reiteration compared to AS. Individuals suffering from personality disorders and those with a history of AS as index case exhibited increased risk for the reiteration of AS. Females, younger individuals, and individuals experiencing SI as first episode were instead identified as more likely to repeat this form of suicidal behavior. Contemporary economic and environmental crises, a recent pandemic, and numerous conflicts represent significant additional menaces to mental well-being. Our analysis highlights a concerning positive trend in suicide attempts and ideations, underscoring the imperative for Public Health Systems to implement targeted preventive strategies and mental health promotion campaigns. In the absence of structured suicide registries, we demonstrated that HDRs can serve as an invaluable foundation for preventionists to address the phenomenon and strategically plan interventions.

Abstract Background Developing an understanding of the negative impact of discrimination is critical when examining the suicidality of Black young adults in the US. Suicide rates among Black young adults have increased at alarming rates. One of the reasons for this increase is the disparities related to access to mental health services, which has long-term health consequences. This study addresses a significant gap in the literature by examining associations between experiences of everyday discrimination, attitudes towards mental health help-seeking attitudes, on the outcomes suicide ideation, planning to die by suicide, and suicide attempts. Methods The data came from a national study of the experiences of Black young adults regarding mental, physical, and sexual health. Participants were recruited from across the Midwestern region of the United States through Qualtrics Panels, an online survey delivery service used to recruit study participants. The total sample for this study was N = 362, and the average age of the sample was 21 (SD: 1.96). We used a logistic regression analysis to examine the role of everyday discrimination, mental health support-seeking attitudes, and covariates on the outcomes: suicide ideation, planning to die by committing suicide, and suicide attempts. Results Black young adults with positive mental health help-seeking attitudes were 34% less likely to attempt suicide (OR = 0.66; 95% CI: 0.46, 0.96) and 35% less likely to experience suicide ideation (OR = 0.65; 95% CI: 0.47, 0.89). However, those young adults who experienced discrimination daily were more likely to report having attempted suicide (OR = 1.70; 95% CI: 1.34, 2.15). Conclusions Our findings offer valuable insights into the complex interplay between experiences of discrimination, attitudes toward seeking mental health support, and suicidal behaviors. However, our research also underscores how experiences of discrimination can significantly exacerbate feelings of isolation, hopelessness, and inadequacy, further contributing to suicidal behaviors in this population. By promoting positive mental health help-seeking behaviors, actively addressing discrimination, and applying an intersectional approach to suicide prevention efforts, we can take significant strides towards building a more supportive and inclusive society. This approach aims to empower individuals to seek help, reduce the risk of suicidal behaviors, and create a more welcoming environment for all members of our community.

Background: Suicide is influenced by multiple factors. However, the mechanisms through which these factors influence suicide remain understudied. This study aims to examine the relationship between parenting styles (warmth, control, indulgence, humiliation, and neglect), coping, self-esteem, depression, and suicidality (suicidal ideation and suicide attempts) among college students. Methods: Cross-sectional data were collected from 2369 undergraduates (mean age = 20.10 years) including 1201 women (50.7%) at four Chinese colleges. Results: Students reported high rates of suicidal behaviors (12.7% suicidal ideation, 6.4% suicidal attempts) and depression (37%). Structural equation modeling indicated that warmth (+) had associations with coping. Coping was linked to self-esteem and depression. Depression (+), self-esteem (−), warmth (−), and neglect (+) had direct correlations with suicidality. Self-esteem mediated the relationships between warmth and depression. Conclusions: Future prevention intervention efforts aimed at reducing depression and suicidal behaviors should prioritize the promotion of positive parenting styles and the avoidance of negative ones. College mental health services should emphasize positive and optimistic coping strategies to enhance students' self-esteem. [ABSTRACT FROM AUTHOR]

This study examined the effectiveness of dialectical behavior therapy (DBT) in a partial hospitalization program (PHP) for adolescents and young adults. In the present study, 146 patients (mean age = 17.5) in a DBT PHP completed surveys assessing suicidality, difficulties in emotion regulation, depression, and anxiety, as well as effective coping skills on their admission and discharge from the program. After a 20-day course of intensive DBT programming, patients showed statistically significant decreases, associated with mostly medium and large effect sizes, in suicidal behaviors, depression, anxiety, stress, and emotion dysregulation. Patients also showed significant increases in the use of mindfulness and functional coping skills. These results demonstrate the significant effects of intensive-level (PHP) DBT delivered over a relatively brief period to adolescents and young adults with severe difficulties. Future studies should explore DBT impact on additional treatment targets and identify the strongest predictors of improved outcomes. [ABSTRACT FROM AUTHOR]

Around the world, suicide ideation, attempts, and deaths pose a major public and mental health challenge for patients (and their loved ones). Accordingly, there is a clear need for effective clinical treatments that reliably reduce suicidal thoughts and behaviors. In this article, we review the Collaborative Assessment and Management of Suicidality (CAMS) and Dialectical Behavior Therapy (DBT), two clinical treatments that rise to the highest levels of empirical rigor. Both CAMS and DBT are now supported by randomized controlled trials (RCTs), with independent replications, and meta-analyses. There are also supportive data related to training clinical providers to use CAMS and DBT with adherence. RCTs that investigate the use of both interventions within clinical trial research designs and the increasing use of these complementary approaches within routine clinical practice are discussed. Future directions for research and clinical use of CAMS and DBT are explored as means to effectively treat suicidal risk. [ABSTRACT FROM AUTHOR]

Background: Developing an understanding of the negative impact of discrimination is critical when examining the suicidality of Black young adults in the US. Suicide rates among Black young adults have increased at alarming rates. One of the reasons for this increase is the disparities related to access to mental health services, which has long-term health consequences. This study addresses a significant gap in the literature by examining associations between experiences of everyday discrimination, attitudes towards mental health help-seeking attitudes, on the outcomes suicide ideation, planning to die by suicide, and suicide attempts. Methods: The data came from a national study of the experiences of Black young adults regarding mental, physical, and sexual health. Participants were recruited from across the Midwestern region of the United States through Qualtrics Panels, an online survey delivery service used to recruit study participants. The total sample for this study was N = 362, and the average age of the sample was 21 (SD: 1.96). We used a logistic regression analysis to examine the role of everyday discrimination, mental health support-seeking attitudes, and covariates on the outcomes: suicide ideation, planning to die by committing suicide, and suicide attempts. Results: Black young adults with positive mental health help-seeking attitudes were 34% less likely to attempt suicide (OR = 0.66; 95% CI: 0.46, 0.96) and 35% less likely to experience suicide ideation (OR = 0.65; 95% CI: 0.47, 0.89). However, those young adults who experienced discrimination daily were more likely to report having attempted suicide (OR = 1.70; 95% CI: 1.34, 2.15). Conclusions: Our findings offer valuable insights into the complex interplay between experiences of discrimination, attitudes toward seeking mental health support, and suicidal behaviors. However, our research also underscores how experiences of discrimination can significantly exacerbate feelings of isolation, hopelessness, and inadequacy, further contributing to suicidal behaviors in this population. By promoting positive mental health help-seeking behaviors, actively addressing discrimination, and applying an intersectional approach to suicide prevention efforts, we can take significant strides towards building a more supportive and inclusive society. This approach aims to empower individuals to seek help, reduce the risk of suicidal behaviors, and create a more welcoming environment for all members of our community. [ABSTRACT FROM AUTHOR]

Mental health issues are prominent among gender minorities; however, research examining these issues among college campuses is limited, and has often overlooked individuals who identify outside of transgender or cisgender identities. Our findings indicated that transgender participants reported the highest rates and frequencies of non-suicidal self injury, suicidal thoughts, and suicide attempt compared to cisgender peers; followed closely by gender-expansive participants. Gender minority participants reported higher rates of family distress and social anxiety. [ABSTRACT FROM AUTHOR]

A meta-analysis was performed to determine pooled prevalence of non-suicidal self-injury (NSSI), suicide behaviors (including ideation, attempts), and associated risk factors among runaway and homeless youth (RHY). The databases PubMed, Scopus, Web of Science, and Cochrane Library were searched for relevant studies published from January 1995 to May 2023. Initially, 8465 papers were screened, resulting in 69 included studies. The results showed that among RHY, lifetime prevalence rates were 42% for NSSI, 38% for suicidal ideation, and 27% for suicide attempts. Lifetime prevalence of NSSI and suicide behaviors was higher among adolescent minors (aged 12–17 years) compared to young adults (aged 18–24 years). Also, NSSI and suicide behaviors were associated with having a childhood history of physical and sexual abuse. Developing an impactful community-based suicide prevention campaign tailored for RHY appears warranted. Peer groups and mentorship programs would provide invaluable support for young individuals, as supportive friendships protect against NSSI. [ABSTRACT FROM AUTHOR]

This study assessed associations between experiences of physical or sexual violence in childhood and self-harm, suicidal ideation, and suicide attempts among young people in low- and middle-income countries (LMICs) and whether these associations varied by sex and perpetrator identity. We used nationally representative data from the Violence Against Children and Youth Surveys in eight LMICs (2017–2019). The analytic sample included 33,381 young men and women (ages 13–24 years). Multivariable logistic regressions with country-fixed effects were used to estimate the associations between childhood physical and sexual violence and the three outcomes. Stratified analyses were performed by country, participant's sex, and type of perpetrator (parent/caregiver, other adults, peers, and intimate partner). About 40% of the participants reported physical childhood violence, and 10% experienced childhood sexual violence. Childhood violence was associated with increased odds of self-harm (physical violence: adjusted odds ratio [aOR]: 2.2, 95% confidence interval [CI]: 2.0–2.4; sexual violence: aOR: 2.7, 95%, CI: 2.3–3.0), suicidal ideation (physical: aOR: 3.0, 95% CI: 2.7–3.3; sexual: aOR: 4.0, 95%, CI: 3.6–4.5), and suicide attempts (physical: aOR: 3.6, 95% CI: 3.2–4.1; sexual: aOR: 4.9, 95%, CI: 4.3–5.7). Consistent findings were observed in country-specific analyses. The odds of all outcomes were highest among those who experienced childhood physical violence by intimate partners and childhood sexual violence by parents or caregivers. Young women who experienced childhood sexual violence had higher odds for all outcomes than young men. Violence prevention and mental health programs for young people in LMICs should consider the types of violence experienced, the perpetrator, and the sex of the survivor. [ABSTRACT FROM AUTHOR]

This study examined how health behavior patterns are associated with anxiety and suicidal behaviors among Korean adolescents. Data were collected from a national cross-sectional sample of adolescents (n = 54,948, 51.5 % boys) in the 2020 Korea Youth Risk Behavior Web-based Survey. Latent class analysis was conducted based on 12 health behaviors (e.g., eating habits, physical activity, and substance use) using the R-based Jamovi 2.3.21 program. Four classes of health behaviors were identified: Class 1 (boys: 45.4 %, girls: 34.4 %) engaged in healthy behaviors; Class 2 (boys: 31.7 %; girls: 22.3 %) had unhealthy eating habits; Class 3 (boys: 18.0 %; girls: 39.9 %) had the lowest physical activity; and Class 4 (boys: 5.0 %, girls: 3.4 %) engaged in substance use, including smoking, drinking, and problematic smartphone use. Overall, girls had a higher odds ratio (OR) for anxiety and suicidal behaviors than boys did. Among girls, Class 4 had a higher OR for anxiety (OR = 2.78, 95 % confidence interval [CI] = 2.40–3.21), suicidal ideation (OR = 3.99, 95 % CI = 3.46–4.62), suicide plan (OR = 3.32, 95 % CI = 2.66–4.16), and suicide attempts (OR = 5.62, 95 % CI = 4.43–7.12) than Class 1. This study has a few limitations including the participants' response bias, the use of a self-report survey, and the lack of diagnosis by clinicians. Adolescents engaging in substance abuse (Class 4) were more prone to anxiety symptoms and suicidal behaviors (ideation, plan, and attempts) than those engaged in healthy behaviors (Class 1). We suggest that more attention is needed to develop suicide prevention strategies that consider adolescent substance use patterns such as current smoking, drinking, and problematic smartphone use. • Four classes of health behaviors among Korean adolescents were identified according to LCA. • Compared to Class 1 (engagement in healthy behaviors), both boys and girls in Class 4 (substance use) were 1.77 and 2.78 times more likely to have anxiety symptoms. • Class 4 had a higher OR for suicidal ideation, suicide plan, and suicide attempts than Class 1. [ABSTRACT FROM AUTHOR]

Youth suicide has been increasing and became a public health concern worldwide. Identifying insufficient sleep as the potential risk factor is critical to reducing suicide risk and increasing trends. This study aimed to determine whether insufficient sleep is associated with increasing trends in suicidal behaviors and disparities by sex, age, and race/ethnicity among school adolescents. The present study used biennial data from the US nationally representative Youth Risk Behavior Survey from 2007 to 2019. Joinpoint regression models were used to estimate biennial percent changes (BPCs) and average BPCs (ABPCs) of suicidal behaviors by sleep duration. Logistic regression models were used to examine the association between insufficient sleep and suicidal behaviors. Of 73,356 adolescent students included (mean [standard deviation] age, 16.11 [1.23] years), 50.03% were female. Suicidal ideation and suicide plan among insufficient sleep group increased from 2007 to 2019 (BPC = 2.88% [95% confidence interval {CI}: 1.65%, 4.13%]; BPC = 3.42% [95% CI: 2.09%, 4.77%]), but were nonsignificant among sufficient sleep group. Trends in suicidal ideation (ABPC = 3.03% [95% CI: 1.35%, 4.73%]) and suicide plan (ABPC = 4.03% [95% CI: 2.47%, 5.62%]) among female adolescents with insufficient sleep increased, but nonsignificant among male adolescents with insufficient sleep. Suicidal ideation (ABPC = 1.73% [95% CI: 0.51%, 2.97%]) and suicide plan (ABPC = 2.31% [95% CI: 0.70%, 3.95%]) increased among younger adolescents only with insufficient sleep, whereas suicide trends by sleep duration were similar among older adolescents. Suicide plan among insufficient sleep group increased across the four racial groups, with BPC highest for the White (BPC = 3.48% [95% CI: 1.31%, 5.69%]), and lowest for the Hispanic/Latino (BPC = 1.18% [95% CI: 0.15%, 2.23%]), but were nonsignificant among sufficient sleep group except for the White (BPC = 2.83% [95% CI: 0.62%, 5.09%]). Insufficient sleep was disproportionately associated with increasing trends in suicidal behaviors among female, younger, and non-White adolescent students. Ensuring sufficient sleep can potentially reduce suicide among school adolescents. [ABSTRACT FROM AUTHOR]

Adolescents with chronic illnesses face unparalleled challenges. To better understand these challenges and their impact on mental well-being, the Strengths and Difficulties Questionnaire Dysregulation Profile (SDQ-DP) was employed as a clinical assessment tool. The primary aim of our cross-sectional study conducted at a tertiary care center was to assess the prevalence of high SDQ-DP scores and its association with depressive symptoms, suicidal behaviors, and health-related quality of life (HRQoL) among adolescents aged 10–18 years diagnosed with various chronic illnesses. Among the 130 participants, 11.5% exhibited high SDQ-DP scores. Adolescents with high SDQ-DP scores displayed significantly higher rates of depression (aOR 12.37, 95% CI 2.15–71.19), suicidal ideation (aOR 18.68, 95%CI 2.72–128.33), suicidal plan (aOR 23.02, 95%CI 3.48–152.24), suicidal attempt (aOR 25.48, 95%CI 2.83–229.17) and diminished HRQoL (p < 0.001). This study has supported the correlation between high SDQ-DP scores and compromised mental well-being, highlighting the tool's clinical significance. [ABSTRACT FROM AUTHOR]

Suicide is a leading cause of death among adolescents. Emerging literature has described relationships between excessive screen time and suicidal behaviors, though findings have been mixed. The objective of this study is to determine the prospective associations between screen time and suicidal behaviors two-years later in a national (U.S.) cohort of 9-11-year-old-children. We analyzed prospective cohort data from the Adolescent Brain Cognitive Development (ABCD) Study (N = 11,633). Logistic regression analyses were estimated to determine the associations between baseline self-reported screen time (exposure) and suicidal behaviors (outcome) based on the Kiddie Schedule for Affective Disorders and Schizophrenia (KSADS-5) at two-year-follow-up. Participants reported an average of 4.0 h of total screen time per day at baseline. At two-year-follow-up, 1.38% of the sample reported at least one suicidal behavior. Each additional hour of total screen time was prospectively associated with 1.09 higher odds of suicidal behaviors at 2-year-follow-up (95% CI 1.03-1.14), after adjusting for covariates. For specific screen time modalities, each additional hour of texting (aOR 1.36, 95% CI 1.06-1.74), video chatting (aOR 1.30, 95% CI 1.03-1.65), watching videos (aOR 1.21, 95% CI 1.04-1.39), and playing video games (aOR 1.18, 95% CI 1.01-1.38) was associated with higher odds of subsequent suicidal behaviors. Higher screen time is associated with higher odds of reporting suicidal behaviors at two-year-follow-up. Future research should seek to identify how specific screen time experiences may influence suicidal behaviors.

Introduction People living with HIV are at increased risk of suicidal behaviors. It is critical to assess risk factors in resource-poor settings. Our study aimed to quantitatively assess the prevalence, pattern, and risk factors for suicidal behaviors among HIV-positive adults. Material and methods Facility-based cross-sectional study among 412 HIV-positive adults over nine months was conducted. Data on participants’ characteristics, prevalence and pattern of suicidal idea­tion, plan and attempt, and risk factors for suicidal behaviors using structured interviews with closed-ended questionnaires were obtained. Crude and specific prevalence, 95% confidence intervals of suicidal behaviors, and risk factors were computed. Subsequently, we conducted bivariate analyses and binary logistic analysis to assess relevant associations, with statistical significance at 5%. Results About two out of every three (68.4%) participants were women. The crude prevalence of suicide behaviors was 7.3%, 6.1%, and 5.8% for suicide ideation, suicide planning, and suicide attempt, respectively. Several risk factors for suicide behaviors were common, such as perception of suicide as a crime (59.7%), lack of access to healthcare (44.7%), social isolation (34.7%), anxiety (32.8%), psychological distress (32.3%), separation or divorce (29.4%), widowhood (23.3%), intimate partner violence (15.5%), and co-existing major medical conditions (14.8). Suicidal behaviors were associated (p < 0.05) with an­xiety, alcohol consumption, co-existing major medical conditions, rape, and lack of access to healthcare. Conclusions Suicidal behaviors and their risk factors are common among people living with HIV. It is critical to prioritize screening for suicide behaviors and their risk factors in HIV care.

Objective: This study aimed to investigate the association between the risk of suicidal behaviors and student-supervisor relationships and subjective family socioeconomic status (SFSS) in medical graduate students, and to propose preventive strategies to reduce the suicidal risk among medical graduate students. Materials and methods: A total of 1,310 validated questionnaires were collected from medical graduate students, which included demographic information, study programs, the Suicidal Behaviors Questionnaire-Revised (SBQ-R) questionnaire, the Leader-Member Exchange 7 (LMX-7) questionnaire, and SFSS by MacArthur Scale. Multiple regression analysis was employed to examine the associations between variables and adjust for confounders. A moderation analysis, containing simple slope analysis and Johnson-Neyman interval plots were used to analyze the moderating effect of the SFSS in the association of SBQ-R and LMX-7 scores. Results: A total of 88 participants (6.7%) were at risk of suicidal behaviors. In the high-quality student-supervisor relationship group (LMX-7 score = 25), SFSS was significantly higher than in the low- and moderate-quality relationship group (p=0.002). The median SBQ-R score and proportion of suicide risk was significantly lower (p<0.001) in the high-quality student-supervisor relationship group. Multiple regression analysis indicated LMX-7 scores (β=-0.098, 95% CI [-0.118, -0.077], p<0.001) and SFSS (β=-0.073, 95% CI [-0.127, -0.019], p=0.008) were significantly negatively associated with SBQ-R, whereas the interaction term of SFSS with LMX-7 (β=0.018, 95% CI [0.007, 0.029], p=0.001) showed a significant positive association with SBQ-R. The Johnson-Neyman interval showed a significant association between LMX-7 and SBQ-R scores only when SFSS was less than 7.82 (p<0.05). Conclusion: The risk of suicidal behaviors was associated with student-supervisor relationships and SFSS among medical graduate students. Poor relationships with supervisor were associated with an elevated risk of suicidality, and SFSSmoderated this association. Educators should pay increased attention to the suicidal risk of medical graduate students with poor supervisor relationships, especially those from families with low SFSS, and provide timely preventive strategies. [ABSTRACT FROM AUTHOR]

Childhood adversity can have detrimental impacts on life course mental and physical health. Timing, nature, severity, and chronicity of adversity are thought to explain much of the variability in health and developmental outcomes among exposed individuals. The current study seeks to characterize heterogeneity in adverse experiences over time at the individual, family, and neighborhood domains in a cohort of predominantly Black children (85% Black and 15% White, 46.2% girls, 67.2% free/reduced lunch in first grade), and to examine associations with mental health from sixth grade to age 26. Participants were part of a randomized universal preventive interventions trial in first grade with prospective follow-up through early adulthood. Separate models characterized heterogeneity in adversity in elementary, middle, and high schools. Changes in adversity over time and relationships with mental health (anxiety, depression, suicidal behaviors) were investigated using a random-intercept latent transition analysis (RI-LTA). We identified three-class solutions in early childhood, middle school, and high school. Generally, both a higher and a lower poly-adversity class were observed at each time point, with varying nature of adversity characterized by the third class. RI-LTA indicated prevalent within-individual changes in adverse exposure over time and differential associations with mental health and suicidal behaviors. Results suggest that treating adverse exposures as a static construct may limit the ability to characterize salient variation over time. Identifying complexity in adverse experiences and their relation to health and well-being is key for developing and implementing effective prevention and early intervention efforts to mitigate negative effects through the life course. Public Significance Statement: Children are exposed to changing forms of adversity across development with differential impacts on mental health. Focusing on repeated, adaptive, coordinated, and multilevel preventive mental health efforts will be crucial to support the well-being of children and adolescents throughout the life course. [ABSTRACT FROM AUTHOR]

• Suicidal ideation and behavior rates in children are increasing. • There is a lack of appropriate suicide interventions for children. • The safety planning intervention (SPI) was modified to fit developmental characteristics of children. • The child SPI (C-SPI) is a dyadic/triadic intervention. • The C-SPI provides tools for suicide prevention for children and caregivers. Suicide rates of children 12 years old and younger have increased in recent years—however, a brief suicide prevention intervention that fits the developmental stage of children in this age group is lacking, creating an urgent need to fill this gap. The safety planning intervention (SPI), which is widely used among adults and adolescents at risk of suicide, was modified into a dyadic/triadic intervention for children and their caregivers to assist in preventing suicidal behaviors among children. In this paper, we describe the modifications made to the SPI to fit children ages 6–12 at risk of suicide and their caregivers' needs, as well as the steps of creating the child-SPI (C-SPI) in detail. The implementation of the C-SPI is illustrated through a case example, and potential challenges are identified. [ABSTRACT FROM AUTHOR]

Clinical and subclinical forms of narcissism may increase suicide risk. However, little is known and there are controversies on this topic. This systematic review aims at providing an overview of studies investigating this association. We used PubMed, Scopus, and PsycInfo databases and followed PRISMA. We focused on cohort, case-control, cross-sectional and case series studies. We referred to both clinical (i.e., narcissistic personality disorder (NPD) and/or NPD criteria) and subclinical forms (i.e., grandiose and vulnerable narcissistic traits) of narcissism. Moreover, we considered: Suicidal Ideation (SI), Non-Suicidal Self-Injury(s) (NSSI), Deliberate Self-Harm (DSH), Suicide Attempt(s) (SA), Suicide Risk (SR), and Capability for Suicide. We included 47 studies. Lack of association between NPD diagnosis/criteria and suicide-related outcomes (SI) or mixed results (SA) were found. Higher homogeneity emerged when considering narcissistic traits. Vulnerable narcissism was associated with SI, less impulsive NSSI, and DSH. Grandiose narcissism was associated with severe NSSI and multiple SA with high intent to die, but it was protective against SI and SR. Vulnerable narcissism seemed to be associated with suicide-related outcomes characterized by low intent to die, while grandiose narcissism seemed to be a risk factor for outcomes with high planning and severity. Between-study heterogeneity and lack of longitudinal studies. Assessing suicide risk in subjects with clinical or subclinical forms of narcissism may be useful. Moreover, considering the most vulnerable form of narcissism, and not just the grandiose one, may contribute to a more nuanced risk stratification and to the identification of distinct therapeutic approaches. [Display omitted] [ABSTRACT FROM AUTHOR]

Objective: Sleep problems are a significant risk factor for identifying and preventing suicidal involvement among adolescents. However, there is limited evidence to assess the underlying mechanisms between them. This study investigated the longitudinal relationship between sleep problems and suicidal behavior and examined whether this relationship was moderated by negative emotions, low self‐control, and nonsuicidal self‐injury (NSSI). Methods: From December 2020 onward, we assessed 1214 Chinese secondary school adolescents (60.7% were boys, aged 13–19 years) three times, 6 months apart. Results: In the direct effects model, sleep problems were found to have a positive impact on adolescent suicidal behavior. In the indirect effects model, we observed that sleep problems were associated with an elevated risk of suicidal behavior through several pathways: one‐mediator path of negative emotions, low self‐control, and NSSI, respectively; two‐mediator path of negative emotions via low self‐control, negative emotions via NSSI, and low self‐control via NSSI, and three‐mediator path from negative emotions to NSSI via low self‐control. Conclusions: This longitudinal study provides evidence that sleep problems in adolescents may increase suicidal behavior by exacerbating negative emotions, weakening self‐control, and promoting NSSI. The findings suggest sleep problems should be addressed in suicide prevention and intervention efforts for adolescents. [ABSTRACT FROM AUTHOR]

Introduction Methods Results Conclusions It has been well documented that men who identify with a sexual orientation other than heterosexual are at a greater risk for suicide‐related outcomes. What is less known are the protective factors that can reduce such negative outcomes and contribute to their resilience.This study used data collected between December 1, 2021, and January 2022 to understand how family factors contribute to or prevent depression symptoms and suicide outcomes among young Black men who have sex with men (BMSM) ages 18 to 29 (N = 400). A path analysis was conducted to explore the direct and indirect effects of suicide attempts.Surprisingly, there were nuanced findings that showed having a family member or friend die by suicide was indirectly associated with suicide planning and suicide attempts. It was also unexpectedly noted that there was a positive relationship between higher rates of depressive symptoms and higher levels of support from family members.The population focused on in this study is understudied and has unique needs. Identifying familial support may not automatically reduce the thoughts and plans of young BMSM, which is an example of why their intersecting marginalized identities must be considered when conducting further research, creating interventions, and providing therapeutic services. [ABSTRACT FROM AUTHOR]

Introduction. Suicide is a public health problem with multifactorial etiology affecting all age groups. In Mexico, the suicide rate was 6.5 suicides per 100,000 population in 2021. Objective. To determine the predictive factors for suicidal behaviors (SB) in college students in the north-central region of Mexico. Method. A descriptive, comparative, analytical study was conducted of 1,147 randomly selected college students. Sociodemographic data, alcohol consumption (AC), perceived stress (PS), social support (SS) and suicidal behavior (SB), suicidal ideation (SI), suicide attempt (SA) and suicide risk (SR) were measured. Data analysis in SPSS included descriptive and inferential statistics. Results. The mean age of study participants was 20.2 years, with a female predominance (82.2%). Prevalence rates for SB were 62% for SI, 14.9% for SA, and 18.3% for SR. In regard to predictive factors for SB, risky, harmful, or dependent AC increased SR 1.7-fold [1.071-2.926]. At the same time, not having SS increased the risk of SI, SA, and SR by a factor of 2.4 [1.843-3.246], 2.7 [1.890-4.123], and 3.6 respectively. Higher PS increased the risk of SI, SA, and SR by a factor of 5.6 [4.209-7.538], 3.1[2.103-4.663] and 6.4 [4.184-9.826] respectively. PS and lack of SS predict SB in both sexes and across all states. Discussion and Conclusion. The results show the importance of mental health care, in both epidemiologically risky situations and everyday life, together with the early identification, and timely, effective treatment of suicide risk factors in university students. [ABSTRACT FROM AUTHOR]

Rehabilitation counselors have a unique role in addressing suicidal and self-injury thoughts and behaviors in people with disabilities. Adults and adolescents with disabilities are at increased risk of suicide and nonsuicidal self-injury (NSSI), necessitating that rehabilitation counselors possess the knowledge and skills to respond systematically and effectively. To address this need, rehabilitation counselors should have access to sufficient education and ongoing training on self-injury terminology, prominent theories, ethical and legal issues related to research and practice, risk/protective factors, and risk assessment processes and instruments. The objective of this article is to provide rehabilitation counseling professionals with an overview of research on suicidality and NSSI, including a review of existing literature related to specific disability groups. Key issues and recommended considerations for rehabilitation counselors are highlighted, including training, risk assessment, evidence-based practice, ethical considerations, self-awareness, and supervision and support. [ABSTRACT FROM AUTHOR]

Around the world, suicide ideation, attempts, and deaths pose a major public and mental health challenge for patients (and their loved ones). Accordingly, there is a clear need for effective clinical treatments that reliably reduce suicidal thoughts and behaviors. In this article, we review the Collaborative Assessment and Management of Suicidality (CAMS) and Dialectical Behavior Therapy (DBT), two clinical treatments that rise to the highest levels of empirical rigor. Both CAMS and DBT are now supported by randomized controlled trials (RCTs), with independent replications, and meta-analyses. There are also supportive data related to training clinical providers to use CAMS and DBT with adherence. RCTs that investigate the use of both interventions within clinical trial research designs and the increasing use of these complementary approaches within routine clinical practice are discussed. Future directions for research and clinical use of CAMS and DBT are explored as means to effectively treat suicidal risk.

Abstract Background Nonsuicidal self-injury (NSSI) combined with suicide ideation increases the risk of suicidal behaviors. Depression and posttraumatic stress disorder (PTSD) are comorbidities of NSSI compounding this relationship. The present study compared diagnostic subgroups of NSSI based on current depression and PTSD on psychological correlates (i.e., vulnerabilities and impairment) and suicidal presentations (i.e., suicidal cognitions and behaviors) in a psychiatric sample of adolescents. Methods Eighty-seven adolescents meeting DSM-5 criteria for NSSI and 104 age-range-matched nonclinical controls (NC) participated. Participants completed self-report measures on psychological vulnerabilities and impairment (e.g., emotion regulation difficulties, negative cognitions). Adolescents with NSSI also completed clinical interviews on psychiatric diagnoses and a recent self-injurious behavior (SIB). Scores on the psychological correlates of NSSI were compared between adolescents with NSSI and NC, and across three diagnostic subgroups of NSSI (A: NSSI+/depression-/PTSD-, n = 14; B: NSSI+/depression+/PTSD-, n = 57; C: NSSI+/depression+/PTSD+, n = 14). Differences between NSSI diagnostic subgroups were tested on the motives for SIB and accompanying suicidal presentations (e.g., desire, intent, motive, lethality). Results Common comorbidities of NSSI included depression, panic disorder, generalized anxiety disorder, and PTSD. The NSSI subgroup classification was significantly associated with panic disorder, which was controlled for in the subsequent group comparisons. Overall, adolescents who engage in NSSI with vs. without depression reported more psychological vulnerabilities and impairment and a greater degree of suicidal thoughts/desire in SIB (i.e., groups B, C >A), which remained significant after controlling for panic disorder. An increased odds of the suicidal motive for SIB was found in adolescents with all three conditions (i.e., group C: NSSI+/depression+/PTSD+) compared to those with NSSI but neither depression nor PTSD (i.e., group A: NSSI+/depression-/PTSD-); however, this was not significant after controlling for panic disorder. Conclusions Psychological underpinnings of adolescent NSSI in clinical contexts may be largely associated with concurrent depression. Suicidal motives in adolescents who engage in NSSI in the presence of depression and PTSD may be confounded by the co-occurrence of panic disorder. This study warrants the importance of attending to the comorbid depression with NSSI in adolescents as it is related to an increase in suicidal desire accompanying SIB.

Abstract Background Electroretinogram (ERG) is one of the tools used to investigate the electrophysiological underpinnings of mental health illnesses and major clinical phenomena (e.g., suicide) to improve their diagnosis and care. While multiple studies have reported specific ERG changes among individuals with suicidal behaviors, we know of no review that has been done to characterize their findings to inform future research. Methods This review included available literature concerning ERG and suicidal behaviors. The paper’s first section briefly overviews the theoretical basis of ERG and neurotransmitters involved in suicidal behaviors. The second section describes the findings of a review of studies reporting ERG findings among individuals with suicidal behaviors. Results Most reviewed studies reported normal amplitude and implicit time of the a-waves, but the latency in individuals with suicidal behaviors was lower than normal. Additionally, the b-waves amplitude was reduced, but the implicit time and latency were increased. The b-a amplitude ratio and oscillatory potential were decreased. Conclusion Despite identifying certain ERG correlates with suicidal behaviors in the existing studies, there is a need for adequately powered and methodologically robust studies to advance clinical translation.

Abstract Background In Canada, ensuring public safety, and the safety and well-being of accused individuals under the jurisdiction of the provincial review board are very important. While previous studies have reported a significant risk of self-harming behaviors (non-suicidal self-injury and suicide attempt) in forensic psychiatric settings, no large population study has assessed any relationship between forensic system-related factors and self-harming behaviors. A better understanding of these factors can help clinicians implement protective measures to mitigate self-harming behaviors or actions. Methods Using the Ontario Review Board (ORB) database covering 2014–2015 period (n = 1211, mean age = 42.5 ± 13.37 years, males = 86.1%), we analyzed the prevalence and factors associated with self-harming behaviors, emphasizing the characterization of the forensic system-related factors (ORB status, legal status, type of offense, previous criminal history, and victim relationship). The relationships between the forensic system-related factors and self-harming behaviors were explored using five separate logistic regression models, controlling for clinical and sociodemographic characteristics. Results Approximately 4% of the individuals in the forensic system over the study period engaged in self-harming behaviors Among the studied patients, individuals determined to be unfit to stand trial and inpatients were significantly more likely to have self-harming behaviors. There was no significant relationship between the type of offence, victim relationship, and previous criminal history with self-harming behavior. Conclusion Forensic psychiatry inpatients should have close observation, screening, monitoring, and individual tailored management strategies for self-harming behaviors. The findings of this study indicate that forensic system-related factors, especially those that pertain to the status of individuals in the forensic system (i.e., unfit to stand trial and being an inpatient) are more responsible for self-harming behaviors among forensic patients in Ontario.

The objective of this meta-analysis was to determine the prevalence of depressive symptoms and suicidal behaviors among high-school students in Iran. A comprehensive search strategy was conducted in the following original databases: PubMed, Web of Science (ISI), Scopus, Psycinfo, and national databases, including the Scientific Information Database (SID) and MagIran, from January 1988 through January 2023. Studies that reported the prevalence of depressive symptoms and suicidal behaviors among high school students in Iran were included. Two investigators extracted all relevant data independently. For deriving mean prevalence rates, random-effects meta-analyses were used. We assessed the quality of studies by the Joanna Briggs Institute (JBI). Total of 67 studies (45,798 participants) were included in the syntheses on depressive symptoms and suicidal ideation. For depressive symptoms, the mean prevalence rate was 48 % (40 %, 55 %). 2804 participants were enrolled for assessing of the prevalence of suicide ideation, and the mean prevalence rate was 21 % (6 %, 36 %). The meta-analysis pooling of the prevalence estimates of suicide attempts was 18 % (15 %, 20 %). Approximately half of the high school students experience depressive symptoms and, astonishingly, one in five high school students experiences suicidal ideation, so to identify strategies for preventing and treating depressive symptoms and suicidal behaviors in this special population, further research and policymaking are urgently needed. • Depression, which affects 4% to 8% of adolescents, is the world's leading cause of life years lost with a highprevalence around maturity • Suicidal ideation, suicide planning, and attempting suicide are different stages of suicidal behavior among high schools. • The mean prevalence rate of depression and suicide ideation were 48% and 21% respectively. [ABSTRACT FROM AUTHOR]

Introduction: We examined data from a large, high acuity, pediatric psychiatric emergency department (ED) to assess both the immediate and longer‐term impact of the pandemic on ED visits for suicidal thoughts and behaviors (STBs) among youth. Methods: Youth ages 5–17 years presenting at a pediatric psychiatric ED in New York, NY from March 2019–November 2021 were included in this study. Visits were categorized as pre‐pandemic, pandemic year 1, or pandemic year 2. We examined changes in demographic and clinical characteristics among patients presenting across the three time periods, as well as multivariable associations between these characteristics and STBs. Results: Over 32 months, 2728 patients presented at 4161 visits. The prevalence of a discharge diagnosis of STBs increased from 21.2% pre‐pandemic to 26.3% (p < 0.001) during pandemic year 1, and further increased to 30.1% (p = 0.049) during pandemic year 2. Youth were 21% more likely to receive a discharge diagnosis of STBs in pandemic year 1 (RR 1.21, 95% CI 1.07, 1.36) and 35% more likely in pandemic year 2 (RR 1.35, 95% CI 1.19, 1.52) compared to pre‐pandemic baseline. Conclusions: In a large, high‐acuity ED, STBs continued to increase 20 months after the initial COVID‐19 lockdown. These findings highlight the persistent detrimental impact of the pandemic on youth mental health. [ABSTRACT FROM AUTHOR]

AbstractDialectical behavior therapy (DBT) and mentalization-based treatment (MBT) are evidence-based approaches to the treatment of borderline personality disorder (BPD), but their implementation in Japan is challenging due to access limitations and attitudinal barriers. This nationwide cross-sectional survey of 153 psychologists in Japan was conducted between 14 October 2021 and 15 November 2021 using a web-based questionnaire. It aimed to assess current BPD diagnoses and treatments, specifically whether standard treatments (such as DBT and MBT) in Western countries are commonly used in Japan. The most common symptoms among patients with BPD were unstable relationships (94.8%) and emotional instability (91.5%). The psychotherapies most commonly used were supportive (52.3%), eclectic (44.4%), psychoanalytic (40.5%), and cognitive behavioral therapy (37.3%). Only 11.8% and 8.5% of psychologists identified DBT or MBT as the main psychotherapy, respectively. The most common drug therapies used were mood stabilizers (64.1%), antidepressants (58.8%), and atypical antipsychotics (49.0%). More than half (56.2%) of psychologists reported that their clients used local networks and social resources. These results provide a deeper understanding of the current management of BPD in Japan. [ABSTRACT FROM AUTHOR]

Objective: Late life anxiety and depression represent a significant source of disability, with racial/ethnic minority older adults in the U.S. showing marked disparities in healthy aging. Community-based organizations (CBOs) and community clinics serve these populations for preventive care, yet few identify their mental health service needs. We examine the association between race/ethnicity and risk of mild-to-severe symptoms of anxiety and depression, and suicidal behaviors in minority older adults. Method: Data come from the multisite randomized controlled trial Building Community Capacity for Disability Prevention for Minority Elders, which screened 1,057 adults (45.5% Asian, 26.8% Latinx, 15.0% non-Latinx Black, 8.5% non-Latinx White, and 4.2% American Indian) aged 60+ years at CBOs and clinics in Massachusetts, New York, Florida, and Puerto Rico. Screened participants completed the Generalized Anxiety Disorder-7 (GAD-7) for anxiety symptoms, the Geriatric Depression Scale-15 (GDS-15) for depression symptoms, and the Paykel Suicide Risk Questionnaire for suicidal behaviors. Results: 28.1% of older adults reported mild-to-severe anxiety symptoms, 30.1% reported mild-to-severe depression symptoms, and 4.3% reported at least one suicidal behavior. Compared to non-Latinx Whites, Latinxs had higher odds of mild-to-severe anxiety and depression symptoms and one or more suicidal behaviors, and Asians had higher odds of mild-to-severe depression symptoms only. Conclusions: There is an urgent need to improve outreach for screening and preventive mental health care for minority older adults. Expanding outreach and community-based capacity to identify and treat minority older adults with mental health conditions represents an opportunity to prevent disability. Public Significance Statement: Our results underscore the importance of outreaching minority older adults participating in community-based organizations (CBOs) and clinics for mental health screening given the high prevalence of anxiety and depressive symptoms, and suicidal behaviors. CBOs and clinics may offer opportunities for early identification of their mental health problems and provide mental health literacy and connection to secondary prevention programs to mitigate their higher risk of disability. [ABSTRACT FROM AUTHOR]

Background: Electroretinogram (ERG) is one of the tools used to investigate the electrophysiological underpinnings of mental health illnesses and major clinical phenomena (e.g., suicide) to improve their diagnosis and care. While multiple studies have reported specific ERG changes among individuals with suicidal behaviors, we know of no review that has been done to characterize their findings to inform future research. Methods: This review included available literature concerning ERG and suicidal behaviors. The paper's first section briefly overviews the theoretical basis of ERG and neurotransmitters involved in suicidal behaviors. The second section describes the findings of a review of studies reporting ERG findings among individuals with suicidal behaviors. Results: Most reviewed studies reported normal amplitude and implicit time of the a-waves, but the latency in individuals with suicidal behaviors was lower than normal. Additionally, the b-waves amplitude was reduced, but the implicit time and latency were increased. The b-a amplitude ratio and oscillatory potential were decreased. Conclusion: Despite identifying certain ERG correlates with suicidal behaviors in the existing studies, there is a need for adequately powered and methodologically robust studies to advance clinical translation. [ABSTRACT FROM AUTHOR]

Background: In Canada, ensuring public safety, and the safety and well-being of accused individuals under the jurisdiction of the provincial review board are very important. While previous studies have reported a significant risk of self-harming behaviors (non-suicidal self-injury and suicide attempt) in forensic psychiatric settings, no large population study has assessed any relationship between forensic system-related factors and self-harming behaviors. A better understanding of these factors can help clinicians implement protective measures to mitigate self-harming behaviors or actions. Methods: Using the Ontario Review Board (ORB) database covering 2014–2015 period (n = 1211, mean age = 42.5 ± 13.37 years, males = 86.1%), we analyzed the prevalence and factors associated with self-harming behaviors, emphasizing the characterization of the forensic system-related factors (ORB status, legal status, type of offense, previous criminal history, and victim relationship). The relationships between the forensic system-related factors and self-harming behaviors were explored using five separate logistic regression models, controlling for clinical and sociodemographic characteristics. Results: Approximately 4% of the individuals in the forensic system over the study period engaged in self-harming behaviors Among the studied patients, individuals determined to be unfit to stand trial and inpatients were significantly more likely to have self-harming behaviors. There was no significant relationship between the type of offence, victim relationship, and previous criminal history with self-harming behavior. Conclusion: Forensic psychiatry inpatients should have close observation, screening, monitoring, and individual tailored management strategies for self-harming behaviors. The findings of this study indicate that forensic system-related factors, especially those that pertain to the status of individuals in the forensic system (i.e., unfit to stand trial and being an inpatient) are more responsible for self-harming behaviors among forensic patients in Ontario. [ABSTRACT FROM AUTHOR]

In the United States (U.S.), premature mortality in adulthood from suicide, alcohol-related disease, and substance overdoses has increased steadily over the past two decades. To better understand these trends, it is necessary to first examine the harmful behaviors that often precede these preventable deaths (i.e., suicidal ideation and attempts, and harmful alcohol and substance use). Representing critical developmental periods in which psychopathology is most likely to emerge, childhood and adolescence provide an informative lens through which to investigate susceptibility to harmful behaviors. This article synthesizes current evidence describing these rising U.S. mortality rates and the prevalence rates of harmful behaviors linked to these types of mortality. A brief selective review of longitudinal research on harmful behaviors in relation to the most relevant categories of child and adolescent psychopathology is then provided. Finally, recommendations for future research and implications for prevention are discussed. [ABSTRACT FROM AUTHOR]

Many studies have identified that adverse childhood experiences (ACEs) are associated with non-suicidal self-injury (NSSI) and suicidality. However, most studies have been restricted to a few types of ACEs. This study aims to investigate the association of 13 common types of ACEs with NSSI, suicidal ideation (SI), and suicide attempts (SA), as well as the mediation of depressive and anxiety symptoms therein. A total of 1771 (994 male, 777 female) students aged 11–16 (12.9 ± 0.6) years who participated in the baseline survey of the Chinese Adolescent Health Growth Cohort study were included in the analysis. ACEs, including childhood maltreatment, other common forms of ACEs, and smoking, were measured via the Chinese version of the Child Trauma Questionnaire (CTQ) and a series of valid questionnaires that were derived from previous studies. NSSI was measured using the Chinese version of the Functional Assessment of Self-mutilation. SI and SA were measured using questions derived from the Global School Based Student Health Survey. Depressive symptoms were measured via the Chinese version of the Center for Epidemiologic Studies Depression Scale, and anxiety symptoms were measured via the General Anxiety Disorder-7. Of the included participants, 92.0% reported one or more category of ACEs. Smoking, parent–child separation, emotional abuse, physical abuse, and being bullied were positively associated with NSSI; smoking, parent–child separation, emotional abuse, physical abuse, emotional neglect, and being bullied were positively associated with SI; smoking, emotional abuse, and being bullied were positively associated with SA. The associations of ACEs with NSSI, SI, and SA were each partially or completely mediated through depressive and anxiety symptoms. Children and adolescents who had experiences of smoking, physical abuse, and being bullied during childhood are consistently and independently associated with NSSI and suicidality, and these associations may be largely mediated through depressive and anxiety symptoms. In conclusion, not all the types of ACEs are independently associated with NSSI, and suicidality and other associations may mediate through depressive and anxiety symptoms. Target interventions for adolescents' NSSI and suicidality should focus on those who have a history of ACEs and depressive and anxiety symptoms. [ABSTRACT FROM AUTHOR]

Abstract Background The worldwide prevalence of suicide ideation, planning, attempt, and death is a major public health issue. The highest rates of suicide are seen in those aged 15 to 29, largely correlating to their time spent in higher education. Objectives Identify the perception and experiences of medical students towards suicidal thoughts and attempts and explore some predictors. Methods A cross-sectional study was conducted at Kafrelshiekh University in Egypt, included 554 university students using predesigned questionnaire that included sociodemographic characteristics, perception of students about suicide, and their experience with knowing a person who had suicide thoughts or attempts and if they themselves had suicidal thoughts or attempts. Results Self-experience with suicidal thoughts was reported by 25.3% while 12.3% reported attempting suicide, and among those who attempted suicide the most frequent reason was feeling depressed (61.8) followed by educational pressures (54.4%) and feeling lonely (41.2%). Accepting the concept of suicide was the main predictor for having suicidal thoughts (OR = 7.784) followed by knowing a person who had suicidal attempt (OR = 2.234) or thoughts (OR = 4.609). Conclusion Our results indicate the suicide ideation and behavior are prevalent among college undergraduates. Universities have the responsibility to educate students with effective life education as well as suicide prevention and intervention programs.

Suicide among young people is an increasingly prevalent and devastating public health crisis around the world. To reduce the rate of suicide, it is important to identify factors that can help us better predict suicidal ideation and behaviors. Adolescent temperament (effortful control, negative emotionality, positive emotionality) may be a source of risk and resilience for the onset of suicidal ideation, plans, and attempts. The present study uses longitudinal data from a large, community sample of Mexican-origin youth (N = 674), assessed annually from age 12 to 21, to examine how temperament is associated with the onset of suicidal ideation and behaviors during adolescence and young adulthood. Results indicate that higher levels of effortful control (activation control, inhibitory control, attention) are associated with decreased probability of experiencing the onset of suicidal ideation, plans, and attempts, whereas higher levels of negative emotionality (particularly aggression, frustration, and depressed mood) are associated with increased probability of experiencing the onset of suicidal ideation and behaviors. Positive emotionality (surgency, affiliation) was not associated with the onset of suicidal ideation and behaviors. Supplemental analyses showed conceptually similar findings for the Big Five, with Conscientiousness associated with decreased risk, Neuroticism associated with increased risk, and the other three dimensions showing largely null results. The findings did not vary significantly for boys and girls or for youth born in the U.S. versus Mexico. Overall, these findings suggest that adolescent temperament serves as both a protective factor (via effortful control/Conscientiousness) and a risk factor (via negative emotionality/Neuroticism) for suicidal ideation and behaviors in Mexican-origin youth. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Background: Suicide is influenced by multiple factors. However, the mechanisms through which these factors influence suicide remain understudied. This study aims to examine the relationship between parenting styles (warmth, control, indulgence, humiliation, and neglect), coping, self-esteem, depression, and suicidality (suicidal ideation and suicide attempts) among college students. Methods: Cross-sectional data were collected from 2369 undergraduates (mean age = 20.10 years) including 1201 women (50.7%) at four Chinese colleges. Results: Students reported high rates of suicidal behaviors (12.7% suicidal ideation, 6.4% suicidal attempts) and depression (37%). Structural equation modeling indicated that warmth (+) had associations with coping. Coping was linked to self-esteem and depression. Depression (+), self-esteem (−), warmth (−), and neglect (+) had direct correlations with suicidality. Self-esteem mediated the relationships between warmth and depression. Conclusions: Future prevention intervention efforts aimed at reducing depression and suicidal behaviors should prioritize the promotion of positive parenting styles and the avoidance of negative ones. College mental health services should emphasize positive and optimistic coping strategies to enhance students’ self-esteem.

Background: The worldwide prevalence of suicide ideation, planning, attempt, and death is a major public health issue. The highest rates of suicide are seen in those aged 15 to 29, largely correlating to their time spent in higher education. Objectives: Identify the perception and experiences of medical students towards suicidal thoughts and attempts and explore some predictors. Methods: A cross-sectional study was conducted at Kafrelshiekh University in Egypt, included 554 university students using predesigned questionnaire that included sociodemographic characteristics, perception of students about suicide, and their experience with knowing a person who had suicide thoughts or attempts and if they themselves had suicidal thoughts or attempts. Results: Self-experience with suicidal thoughts was reported by 25.3% while 12.3% reported attempting suicide, and among those who attempted suicide the most frequent reason was feeling depressed (61.8) followed by educational pressures (54.4%) and feeling lonely (41.2%). Accepting the concept of suicide was the main predictor for having suicidal thoughts (OR = 7.784) followed by knowing a person who had suicidal attempt (OR = 2.234) or thoughts (OR = 4.609). Conclusion: Our results indicate the suicide ideation and behavior are prevalent among college undergraduates. Universities have the responsibility to educate students with effective life education as well as suicide prevention and intervention programs. [ABSTRACT FROM AUTHOR]