Negative emotions have been well studied in relation to suicidal thoughts and behaviors (STBs); however, little research in these areas have been informed by affective science frameworks that consider the complex and time varying nature of STBs. Emotion differentiation is well-validated as one such core construct in affective science. The present study is the first to examine negative emotion differentiation in relation to STBs and in a sample at heightened risk for suicide. In addition, to investigate how emotion differentiation relates to real time measures of emotion regulation, we examined the relationship between negative emotion differentiation and facets of affective dynamics (i.e., affective inertia, intensity, and variability). Adults leaving psychiatric inpatient care (n = 68) with recent STBs completed semi-structured interviews, self-report measures, and a 4-week ecological momentary assessment (EMA) protocol in the period from 2021 to 2023. Results indicated no significant relationship between negative emotion differentiation and STBs (suicidal ideation duration, frequency, controllability, severity, nor suicide attempt history) when measured retrospectively or concurrently. However, negative emotion differentiation was significantly related to only some negative affective dynamics (i.e., inertia and variability). These findings have important clinical implications regarding type and timing of treatment for STBs.

Suicide is a leading cause of death for adolescents and cross-sectional research suggests adolescents experiencing suicide attempts have more negative help-seeking attitudes. Less is known about the effect of suicidal experiences on subsequent help-seeking attitudes. The present study examined reciprocal, longitudinal associations between help-seeking attitudes and suicide attempts. 8469 students from 20 high schools on the wait-list condition of a cluster randomized trial of a universal school-based suicide prevention program were included. Adolescents were assessed in grades 9-12 at four waves. Cross-lagged panel models estimated bidirectional associations between suicide attempts and help-seeking attitudes. Analyses collapsed across gender indicated students reporting negative attitudes towards help-seeking and suicide were more likely to engage in a subsequent suicide attempt. Students with reported suicide attempts reported more negative later attitudes. Attitudes towards help-seeking and suicide predicted suicide attempts in both genders, whereas attempting suicide influenced help-seeking attitudes in girls, rather than boys. Results suggest both boys and girls would benefit from interventions fostering positive attitudes towards help-seeking, such as the Sources of Strength intervention. Adolescents who attempt suicide are also particularly vulnerable to negative help-seeking attitudes, which may be influenced by the severity of psychological distress and interventions received post-attempt.

Bisexual individuals face elevated suicide risk, yet relatively little is known about short-term fluctuations in suicidal ideation (SI) and related constructs within this population. This study compared the frequency and variability of SI facets among bisexual and heterosexual college students. Sixty-two students (38 heterosexual; 24 bisexual) completed ambulatory assessments five times daily for 10 days, rating suicidal desire, wish to live (WTL), and wish to die (WTD). Analyses included generalized linear models and descriptive and variability statistics. Bisexual participants reported lower WTL and higher suicide desire and WTD than heterosexual peers, with the most robust effects observed for WTD. Bisexual participants were also more likely to endorse non-zero suicidal desire and WTD and experienced more frequent large moment-to-moment changes in these constructs. Models revealed similar variability in suicidal desire and WTD across groups, whereas bisexual individuals exhibited modestly higher variability in WTL. Findings suggested that bisexual individuals not only reported higher levels of suicidal desire and WTD but also experienced these states more frequently, with more frequent acute shifts over time. These results highlighted the importance of monitoring short-term fluctuations in suicidal thoughts and behaviors when assessing suicide risk in bisexual populations.

The Integrated Motivational-Volitional (IMV) Model of Suicidal Behavior places defeat and entrapment central to the development of suicidal ideation. Factors such as loneliness and resilience may moderate risk. This study examines the longitudinal relationship between these variables. Secondary data from the UK COVID-19 Mental Health and Wellbeing Study (COVID-MH) were analyzed (n = 2518). Defeat, entrapment, loneliness, resilience, and suicidal ideation were measured across 3 waves (March to May 2020). Six longitudinal mediation models were tested, each with wave 2 entrapment (or subscales) as mediator of wave 1 defeat and wave 3 suicidal ideation. Loneliness and resilience (from waves 1 and 2) were included as moderators of the associations between defeat and entrapment with suicidal ideation. Wave 2 entrapment mediated the relationship between wave 1 defeat and wave 3 suicidal ideation, controlling for wave 1 entrapment and suicidal ideation. Wave 1 loneliness and resilience moderated the pathway from defeat to entrapment, but wave 2 resilience or loneliness did not moderate the pathway from entrapment to suicidal ideation. Findings provide robust longitudinal support for the motivational phase of the IMV model and highlight the importance of targeting entrapment and loneliness and enhancing resilience.

Youth experiencing high levels of functional impairment may be at risk for suicidal ideation, but variables contributing to this risk remain unclear. The present study investigates the role of perceived burdensomeness toward others as an explanatory variable in the association between functional impairment and suicidal ideation in a sample of clinically referred youth, and whether this relationship differs by age. N = 383 clinically-referred youth aged 6 to 17 (Mage = 10.17, SDage = 2.96; 81.8% Hispanic) completed measures of impairment, perceived burdensomeness, suicidal ideation, and depressive symptoms. Functional impairment was significantly associated with perceived burdensomeness (B = 0.39, p < 0.001), and perceived burdensomeness was significantly associated with suicidal ideation (B = 0.02, p < 0.001). The indirect effect of impairment on suicidal ideation through perceived burdensomeness was statistically significant (B = 0.005, SE = 0.002). The conditional indirect effect was significant and strengthened as a function of age. These findings provide novel evidence that perceived burdensomeness may explain the link between impairment and suicidal ideation in youth, and that this explanatory link strengthens with increasing age. Clinically, results underscore the need for developmentally tailored interventions that target perceptions of burdensomeness to mitigate suicidal thoughts in at-risk youth.

Nonsuicidal self-injury (NSSI) is recognized as a global public health concern among adolescents. Although some studies have explored the relationship between self-disgust and NSSI, the discussion remains limited, and the underlying mechanisms have yet to be fully elucidated. This study examined the longitudinal effects of self-disgust on NSSI, as well as the potential indirect effects of depression and psychache on this relationship. A total of 832 Chinese adolescents participated in a two-wave longitudinal study with a six-month interval. The structural equation model was used to investigate the chain mediating roles of depression and psychache in the relationship between self-disgust and NSSI. The findings indicated that higher levels of self-disgust were predictive of NSSI 6 months later. The higher levels of depression were predictive of psychache 6 months later. Additionally, depression and psychache played chain mediating roles in the relationship between self-disgust and NSSI. This longitudinal study provides evidence that self-disgust may contribute to adolescent NSSI by promoting depression and exacerbating psychache. These findings highlight the importance of addressing self-disgust in prevention and intervention strategies aimed at reducing NSSI risk among adolescents.

Social comparison is a socio-cognitive process that can increase risk for suicidal thoughts through feelings of defeat and entrapment. However, its role as a risk factor for racially minoritized individuals remains unclear. This study examined whether social comparison and subjective social rank (one's perceived position derived from social comparison) predict suicidal thoughts via defeat and entrapment particularly for racially minoritized young adults. College students from predominantly White institutions (N = 409) completed online surveys at baseline and one-month follow-up. Eligible participants reported moderate depressive symptoms and/or recent suicidal ideation. Path analyses showed that perceived social rank is a risk factor for suicidal thoughts across racial groups, but may lead to defeat and entrapment only for White students. Thus, perceived social rank may be vital in understanding suicide risk among young adults, but the processes may differ for racially minoritized young adults. Learning how and why racially minoritized young adults develop perceptions of lower social rank may help to identify more equitable suicide prevention interventions.

Suicide is a leading cause of death among young males in Australia. Tomorrow Man's "Breaking the Man Code" workshops aim to challenge potentially harmful masculine norms and promote positive attitudes towards help-seeking among adolescent boys in schools. Our stratified cluster randomized trial was undertaken with 1225 boys (mean (SD) age = 15.04 (0.74) years) across 24 Australian secondary schools: 13 randomized to intervention, 11 to waitlist control. Primary outcome was mean change in intentions to seek help for personal or emotional problems 4 to 8 weeks from baseline. Secondary outcomes included conformity to masculine norms, depression risk, perceived social support, and quality of life. Purpose-designed closed-ended questions captured other behavioral and attitudinal changes. The trial was prospectively registered with ANZCTR. Estimated mean change in scores from baseline between the two groups on the primary outcome was -0.07 (95% confidence interval: -1.75, 1.62; p = 0.937). Purpose-designed questions revealed increased help-offering, connection with friends, and some potential barriers to change. Further research is needed to understand the impacts of school-based interventions for boys. Prospectively registered with ANZCTR: ACTRN12620001134910.

Self-inflicted firearm injuries are a significant public health concern and account for approximately two-thirds of firearm deaths in the United States. Previous research has shown increased self-inflicted firearm injuries in rural populations compared to urban areas. We hypothesize that hospitalization prior to self-inflicted firearm injury event is related to different characteristics in the urban and rural populations. The 2016-2020 Nationwide Readmission Database of the Healthcare Cost and Utilization Project was used to identify hospital admissions within the same year prior to a self-inflicted firearm injury in patients > 12. We identified 6883 self-inflicted firearm injury admissions with 1532 (22.3%) patients having prior admission to the hospital. Of those that survived, there were similar proportions in age groups and urban/rural designation. Rates for prior hospitalizations for suicide were 25% and 30% for the urban and rural cohorts, respectively. Prior to the self-inflicted firearm injury, urban and rural hospitalizations included: infection (41.4% vs 44.7%), mental health (20.8% vs 25.1%), drug/alcohol (8.2% vs 4.5%), and injury (3.6% vs 1.7%), respectively. No prior hospitalizations included other types of firearm injury. The most common diagnosis related groups were infection, mental health, and medical-related problems. We found a 22.3% rate of previous hospitalization prior to self-inflicted firearm injury admission. Despite known differences in the urban and rural populations, hospital admission diagnoses prior to self-inflicted firearm injury are similar between these two groups.

This study aims to examine the five-year evolution of NSSI and identify the predictive factors associated with its persistence. Adolescents aged 12-18 years who attended a CAP outpatient clinic between 2014 and 2016 were retrospectively reviewed. Those with a history of NSSI formed the study group, while those without NSSI comprised the control group. Of 126 adolescents with NSSI, 51 were successfully re-evaluated five years later. The participants' mean age at T1 was M = 15.5 years, and at T2 it was M = 22.0 years. Adolescents who continued to engage in NSSI showed significantly greater difficulties in impulse control, body effectiveness, and identity diffusion compared to those who discontinued the behavior. In logistic regression analysis, identity diffusion and body effectiveness were significant predictors of persistence. Higher identity diffusion had nearly 18 times higher odds of maintaining NSSI (OR 17.99 95% CI [2.195, 147.418]), and those with higher body effectiveness had 1.4 times higher odds of persistence (OR 1.40 95% CI [1.115, 1.774]). Identity diffusion showed the strongest association with persistent NSSI, whereas higher body effectiveness was modestly related to its continuation. These findings point to potential links between identity- and body-related processes and the long-term continuation of NSSI.