Exploring Suicide Potential and the Actualising Tendency: A Qualitative Study of Suicide Notes

The burden of Parkinson's disease: a worldwide perspective

PurposeTo describe the psychosocial protective and risk factors for perinatal mental health identified in a sample of Aboriginal women’s Kimberley Mum’s Mood Scale (KMMS) assessments and explore the role of these factors in their screening assessment and diagnostic outcome.MethodsWe used a mixed methods approach to retrospectively analyse a cross-sectional study dataset of 91 completed KMMS assessments. This included: categorising the clinical notes from the KMMS psychosocial yarn into ‘risk’ and ‘protective’ factors and describing these categories, describing the number and type of risk and protective factors associated with different KMMS risk assessment categories (no, low, medium, high), and exploring relationships between these risk and protective factors and diagnosis of perinatal depression and/or anxiety.ResultsProtective factors were recorded for the vast majority of the women; the most prominent was positive family relationships. When protective and risk factors were stratified by KMMS risk category, women in the higher risk group less commonly had specific protective factors (11–33% high vs 61–100% no risk) and more commonly had risk factors (22–67% high vs 6–28% no risk) than women with lower KMMS assessed risk. The average number of protective factors decreased with increasing KMMS risk category (4.9 ± 1.1 to 1.6 ± 1.3), with the inverse pattern for risk factors (1.1 ± 1.1 to 3.8 ± 1.0). Having protective factors also appeared to reduce the risk of developing clinical depression or anxiety.ConclusionAssessing protective factors in mental health screening for perinatal Aboriginal women increases the effectiveness of screening and provides a foundation for the delivery of local structured psychosocial care.

본 연구는 청소년의 위험 및 보호요인과 스트레스 그리고 행복감과의 관계를 알아보고, 청소년의 위험 및 보호요인과 행복감의 관계에서 스트레스의 매개효과를 밝히고자 하였다. 이를 위해 초ㆍ중ㆍ고등학교에 재학 중인 청소년 806명을 대상으로 위험요인 및 보호요인척도, 스트레스척도,행복감척도를 사용하여 자료를 수집하였고 t검증, F검증, 위계적 회귀분석, 매개효과 검증을 실시하였다. 연구결과를 정리하면 첫째, 고등학생의 행복감이 가장 낮게 나타났으며, 학업성적이 좋고, 부모님과 함께살고, 월평균 소득수준이 높을수록 행복감이 높게 나타났다. 둘째, 위험요인과 스트레스는 행복감과 부적 상관을 보이고 있으며, 보호요인은 행복감과 정적 상관을 보였다. 셋째, 위험요인이 행복감에 유의한 부적영향(설명량 42.7%)을 미치고 있으며, 보호요인은 행복감에 유의한 정적영향(58.4%)을 미치고 있는 것으로 나타났다. 특히 위험요인 중에서 개인위험요인, 가족위험요인, 또래위험요인, 학교위험요인 순으로 행복감이 낮게 나타났으며, 보호요인 중에서 개인보호요인, 가족보호요인, 학교보호요인 순으로 행복감이 높게 나타났다. 넷째, 청소년의 위험 및 보호요인과 행복감 간의 관계에서 스트레스의 매개효과가 있는지를 살펴본 결과 위험 및 보호요인이 행복감에 직접적인 영향을 미치면서, 스트레스를 통한 부분 매개효과가 있는 것으로 나타났다.The purpose of this study is to examine relationships between risk or protection factors and happiness in adolescents, and so analyze the mediating effects of stress on relationships between risk or protection factors and happiness in adolescents. For this purpose, using risk factor and protection factor scales, stress scales, and happiness scales, this study conducted t-test, F-test, hierarchical regression analysis, and mediating effects over the subjects of 806 adolescents attending elementary, middle, and high schools. The results of this study are as follows. First, high school students’ happiness was the lowest. In addition, if academic achievements were better and students lived with their parents and average monthly incomes were higher, happiness was higher. Second, risk factors and stress were negatively correlated with happiness, whereas protection factors were positively correlated with happiness. Third, risk factors had significant negative effects on happiness (explanatory power = 42.7%) as well as protection factors had significant positive effects on happiness (explanatory power = 58.4%). Especially, among risk factors, individual risk factors, family risk factors, peer risk factors, and school risk factors had lower effects on happiness in order. In contrast, among protection factors, individual protection factors, family protection factors, and school protection factors had higher effects on happiness in order. Fourth, according to the results of examining whether stress had mediating effects on relationships between risk or protection factors and happiness, risk and protection factors had direct effects on happiness as stress had partial mediating effects.

This article examines a model in which protective factors are expected to reduce the impact of economic, family, and community risk factors on parental well-being. Parental well-being, marital happiness, and parents' community resources are expected to show positive relationships to parenting behavior. The model is tested through an analysis of data from parents and adolescents and interviewed for the National Commission on Children 1990 Survey of Parents and Children. The results indicate that, although risk factors are negatively related to parental well-being, the protective factors do not buffer these relationships. However, two protective factors, marital happiness and perceived school environment, are positively related to parental well-being. These factors reveal independent compensatory effects on parental well-being, rather than buffering or protective effects. Parental well-being, marital happiness, and parents' community resources show modest positive relationships to nurturing and supportive parenting behavior. Key Words: community resources, parental well-being, parenting behavior, protective factors, risk factors. In recent years, researchers have proposed a model in which parental well-being influences parenting behavior, which, in turn, affects adolescent wellbeing. Although a great deal of research has investigated relationships between parenting behavior and adolescent well-being, studies of the determinants of parenting practices and behavior are relatively limited. In addition, some possible influences on parenting behavior, such as school and neighborhood environments, have been neglected. This article examines a model that integrates the ecological systems model of human development with the analysis of risk and protective factors. In this model, we expect protective factors to reduce the impact of economic, family, and community risk factors on parental well-being. We expect parental well-being, marital happiness, and parents' community resources to show positive relationships to nurturing and supportive parenting behavior among parents of adolescents aged 10-17. Several researchers using an ecological approach have considered risk and protective factors in relation to adolescent well-being. However, these concepts also may be useful for the analysis of parenting behavior. Recent studies of the determinants of parenting behavior have used a framework based on stress, support, and coping (Belsky, 1984; Conger & Elder, 1994; Simons, Beaman, Conger, & Chao, 1993; Simons, Lorenz, Wu, & Conger, 1993). Haggarty, Sherrod, Garmezy, and Rutter (1994) document the transition from the analysis of stress and coping to a framework using the concepts of risk and protective factors. These concepts have advanced the analysis of stressmoderating processes (Gore & Eckenrode, 1994). Risk factors are conditions or variables associated with compromised health, well-being, or social performance. Protective factors, such as dispositional attributes, family milieu, or the extrafamilial social environment, decrease the likelihood of such negative outcomes. Protective factors reflect positive mechanisms or processes that reduce the effects of negative processes associated with risk factors (Garmezy, 1985; Jessor, 1992; Jessor, Van Den Bos, Vanderryn, Costa, & Turbin, 1995). A strict definition of protective factors requires that they buffer or reduce the effects of risk factors on outcomes (Rutter, 1987). This approach is followed in Jessor's (1992) conceptual framework for adolescent risk behavior and health-compromising outcomes, which includes risk and protective factors in the areas of biology, social environment, perceived environment, personality, and behavior. (See Jessor et al., for empirical support of this approach.) When variables decrease the likelihood of negative outcomes independently of risk factors, they often are referred to as independent compensatory factors. …

Background COVID-19 had a considerable impact on the mental and physical health of youth. To limit the impact of this crisis on their health, resilience was required. This study aims to discover how resilient, in terms of mastery, emotional reactivity and social support, groups of youth with different SES were during COVID-19, and what risk and protective factors they experienced. Methods Two qualitative datasets were analyzed. One dataset included 10 interviews of university students during April-May 2020, and the other dataset included 8 interviews with pre-vocational secondary education adolescents during October 2021 to March 2022. Interviews were held in person or online. Data were analyzed with thematic analysis in Atlas.ti. Results In general, university students displayed resilience despite the tumultuous beginning of the pandemic, and their mental and physical health was positive. Protective factors that helped them during COVID-19 were spending time with friends and family, being healthy and having a healthy lifestyle, and being able to avoid stressful situations. Risk factors that impacted their resilience were loneliness, COVID-19 anxiety, and missing stability and routine. Adolescents receiving pre-vocational secondary education showed mixed resilience later in the COVID-19 period, and they made negative observations about their health. Protective factors that helped them were achieving good results in school, hobbies, and avoiding stressful situations. Risk factors they experienced were lack of motivation and having difficulties at school. They experienced worry about school progress during COVID-19. Conclusions University students and lower educated adolescents seemed to have differing resilience during the impactful stages of COVID-19, possibly due to differences in their psychological development. To protect their well-being, it is important that policy makers consider the protective and risk factors that impact the health of youth during crises. Key messages • Resilience differs among the two different age groups and education levels. • Policy makers should consider the protective and risk factors that impact the health of youth during crises.

Since the 1970s, suicide has been a major public health issue in Greenland. The World Health Organization has emphasised the importance of the identification of both risk and protective factors in relation to suicide. The aim of this paper was to identify scientific literature on risk and protective factors for suicide and suicidal behaviour among Greenland Inuit. Searches in PubMed and PsycInfo resulted in 420 studies that were screened by three of the authors. After screening, the authors included 15 studies that were subject to quality assessment and data extraction. All 15 studies reported on risk factors, and only three mentioned protective factors. Most reported risk factors were on an individual level and were related to socioeconomic status, mental health, alcohol and substance use, and life stress. Risk factors related to the family mainly related to adverse childhood experiences, while the community level concerned access to education, work, and conflicts. The results indicate a large knowledge gap about protective factors for suicide and suicidal behaviour. The few protective factors reported were related to men having a family, high socioeconomic status, and being born between 1901 and 1950.

Studies have shown that there are protective and risk factors related to cyber dating violence. However, the effect size of these factors is unclear. This study aims to clarify the effect size of the associations of protective and risk factors, as well as symptoms of mental health conditions, with cyber dating violence perpetration and victimization. Databases, including PubMed, Web of Science (WoS), ProQuest, Scopus, and EBSCOhost were searched to identify relevant studies. Forty-nine studies were included in the current study. Results revealed statistically significant and medium relationships between cyber dating violence perpetration and some risk factors, including offline dating violence perpetration-related factors (i.e., physical, psychological, sexual, relational, verbal/emotional, and threat) and offline dating violence victimization-related factors (i.e., physical and psychological); and small relationships with other risk factors (i.e., sexual offline dating violence victimization, attachment styles, and jealousy), protective factors (i.e., family support and emotional regulation), and mental health symptoms (i.e., depression, anxiety, and alcohol use). There was also statistically significant and robust relationship between cyber dating violence victimization and verbal/emotional offline dating violence victimization (i.e., risk factor); medium relationships with some risk factors, including offline dating violence perpetration-related factors (i.e., psychological and verbal/emotional) and offline dating violence victimization-related factors (i.e., physical, psychological, sexual, relational, and threat); small relationships with other risk factors (i.e., physical offline dating violence perpetration, attachment styles, childhood sexual abuse), protective factors (i.e., family support, emotional regulation, and self-esteem), and mental health symptoms (i.e., depression, anxiety, stress, alcohol use, and drug use). The study's results highlight risk and protective factors associated with cyber dating violence and demonstrate its association with mental health symptoms.

Guided by a resilience framework, this study examines the accumulation of risk and protective factors, as well as the potential buffering effects of protective factors on mental distress among female military spouses. Most research with this population has focused on individual risk factors affecting military spouses. Less frequently have the effects of cumulative risk, risk factors not specifically associated with military service, or protective factors been examined, though there is evidence for their importance. This study used secondary survey data from 334 female Army spouses collected in 2012 as part of the Land Combat Study 2. Cumulative risk and protective factor scores as well as scores within risk (intrapersonal, family, and military-specific) and protective (individual and environmental) factor domains were calculated. Four structural equation models were run to examine main and interaction effects on mental distress, a latent variable representing depression, anxiety, and trauma symptoms. In cumulative risk and protective factor models, cumulative risk was directly, positively associated with mental distress. This relationship was moderated by cumulative protection. In domain-specific models, only family risk was directly associated with mental distress. This relationship was moderated by environmental protective factors. Findings indicate mental distress among military spouses is associated with exposure to cumulative risk and attenuated by the presence of certain domains of protective factors. Family risk factors including marital distress and work-family conflict may be particularly pernicious stressors, but informal and structural supports may be important targets for prevention and intervention efforts. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Symptoms characteristic of autism spectrum disorder were initially believed to protect individuals with autism spectrum disorder from developing substance abuse. However, recent studies suggest that up to 36% of individuals with autism spectrum disorder may have a co-occurring issue with substance abuse. In addition, substance abuse may worsen the difficulties with daily functioning some individuals with autism spectrum disorder experience. It is important to understand occurrence rates, and risk, protective and positive treatment factors of co-occurring autism spectrum disorder and substance abuse in order to promote the best possible support for this special population. This review aimed to find and synthesize evidence regarding risk, protective and treatment factors, and determine a general prevalence rate of co-occurring autism spectrum disorder and substance abuse from all studies on substance use and abuse in individuals with autism spectrum disorder. The review also aimed to assess study quality and identify a diagnostic measure for substance abuse in individuals with autism spectrum disorder. Twenty-six studies on substance use and abuse in autism spectrum disorder were included in the review. The rates of substance abuse among those with autism spectrum disorder identified by included studies ranged from 1.3% to 36%, but due to large differences in study methods, a general prevalence rate could not be determined. Risk and protective factors, recognized in the general population, such as familial substance abuse and co-occurring mental health issues, and factors which may be more likely to occur in individuals with autism spectrum disorder, such as limited social resources and low sensation-seeking, were identified. No diagnostic measures specific to individuals with autism spectrum disorder and substance abuse were identified. This review identified only one exploratory study on an adapted intervention for co-occurring autism spectrum disorder and substance abuse. However, there were many methodological challenges in this study that limit the conclusions that can be drawn from the data. More research, using consistent methods, is needed to understand risk and protective factors and to determine the prevalence of substance abuse among individuals with autism spectrum disorder. The potential for co-occurring autism spectrum disorder and substance abuse should be considered by professional working in both autism spectrum disorder and substance abuse services, as finding suggests substance abuse is possible among individuals with autism spectrum disorder and may occur more frequently than previously believed. In addition, autism spectrum disorder and substance abuse service providers should be sensitive to specific risk and protective factors identified by the review that may impact substance abuse course and outcomes.

The purpose of this study was to examine the comparative influences of various protective and risk factors on the alcohol-related problems of a sample of university students. The conceptualization of these protective and risk factors in the current undertaking was informed by problem behavior theory, and draws heavily on two sociological theories of deviant behavior (social learning theory and social bond theory). A questionnaire containing indicators measuring various protective and risk factors, as well as various alcohol-related problems, were administered to a sample of 1,459 students from four colleges and universities. The results indicated that both risk and protective factors were associated with alcohol-related problems in this sample. However, risk factors explain a far greater amount of variance in these problems. Implications for campus programming designed to reduce alcohol-related problems are discussed.

This study evaluated the impact of structured training in evidence-based risk assessment for suicide. Forty-five psychiatry and psychology trainees participated in a workshop on evidence-based risk assessment. A comparison group of ten psychiatry trainees participated in a different workshop on the application of evidence-based medicine to psychiatry that was not focused specifically on risk assessment. Before and after each workshop, participants rated their skills in assessing patients' risk of suicide and wrote progress notes regarding clinical vignettes that included the assessment of and plan regarding suicide risk. Researchers systematically rated the progress notes. Participation in risk assessment training predicted improvement on specific indicators of documentation quality, ratings of the overall quality of documentation of suicide risk, and self-rated competence in suicide risk assessment. Structured clinical training in evidence-based risk assessment can improve documentation of assessment and management of patients' risk of suicide.

Children of parents with drug and alcohol use disorders often grow up under severe stress and are at greater risk of developing psychological and social problems. However, a substantial proportion of affected children adapt to their distressing life conditions and show positive development in terms of their mental health. These children are described as resilient. One difference between resilient and maladapted children is the presence of protective factors. The aim of this systematic review is to provide an overview of the current state of the research concerning protective mental health factors in children of parents with alcohol or drug use disorders (COPAD). For that purpose, the PsychInfo, PubMed, CINAHL and ISI Web of Science databases were searched through January 2017. All the identified publications were screened using previously developed inclusion criteria. The search yielded 3,402 articles. Eleven of these publications (2003–2013) met the criteria for inclusion in the present review. Information on the studies was extracted using an extraction form. A narrative analysis was performed, and the methodological quality was examined using a checklist based on the Mixed Methods Appraisal Tool. The research identified familial, parental, child-related and biological factors that influenced mental health outcomes in affected children (N = 1,376, age range = 1–20 years). Overall, protective mental health factors are understudied in this target group. Most of the included studies were conducted in the United States and employed a cross-sectional design. A comparison of the included cross-sectional and longitudinal studies indicated consistent results related to a secure parent-child attachment. Based on the current state of the research, no causal conclusions with regard to the effectiveness of protective factors can be drawn. To develop effective prevention programs, further longitudinal studies and studies assessing the interactions between risk and protective factors are needed.

The COVID-19 pandemic has significantly impacted nurses, exposing them to challenges that have affected their overall well-being. Most nurses have experienced psychosocial problems, including anxiety. This study aims to identify the protective and risk factors associated with anxiety among nurses during the COVID-19 pandemic. A systematic review was used as a method in this study. Eight databases were used Science Direct, PubMed, CINAHL, Embase, ProQuest, Scopus, Taylor & Francis, and JSTOR. The literature search was conducted using keywords derived from the Medical Subject Headings (MeSH) framework. The search terms included: Nurses OR "staff nurses" OR "healthcare professionals", AND "factors associated with anxiety" OR "risk factors" OR "protective factors", AND "COVID-19" OR "COVID-19 pandemic". The data were further analyzed by critically assessing the quality of the articles using the JBI and CASP checklists. The research articles included in the review were cross-sectional studies published between 2020 and 2022, written in English, available in full text, and specifically focused on protective and risk factors for anxiety. A risk of bias assessment was conducted using the Joanna Briggs Institute quality assessment checklist. A total of 33 articles were reviewed, revealing two primary themes of protective and risk factors: internal and external factors. Internal factors included variables such as age and gender, while external factors encompassed aspects such as hospital status. Based on the findings, it is recommended that hospitals implement mental health and psychosocial support interventions as promotive and preventive efforts to improve the nurses' psychological well-being.

Prevention of Depression in Children and Adolescents

Adolescents and risks: Why not change our paradigm?