Higher Levels Of Suicidal Ideation Research Articles

Associations of Suicidality with Adverse Life Events, Psychological Distress and Somatic Complaints in a Chinese Medical Student Sample.

The present study aimed to examine the associations of suicidality with psychological distress, somatic symptoms, and stressors in medical school students. We conducted a cross-sectional survey of medical students at a large, top-ranked medical school. A total sample of 662 medical students (269 men) completed a battery of self-reported questionnaire. Of the respondents, 136 (20.5%) reported having suicidal ideation, 40 (6.0%) reported having planned suicide, and 10 (1.5%) reported having attempted suicide during the previous year. Students from rural areas and the 3rd year of study reported higher levels of suicidal ideation than their counterparts. General pain/fatigue was associated with suicidal ideation and planning, while interpersonal difficulties were associated only with suicidal ideation. This study provides evidence linking severe psychological distress, general pain/fatigue, interpersonal stress and psychosocial factors with suicide risk among Chinese medical students which provides targets for future psychological interventions.

Depression and Suicidal ideation among Mothers of Children with disability; An Examination of Moderating Effects of Resilience

This study examines the role of resilience on the relationship between depression and suicidal ideation among mothers of children with mental retardation. The sample for this study was drawn from several special education schools in South Korea. A total of 234 mothers of children with mental retardation completed the survey. The finding indicated that increased depression is associated with a high level of suicidal ideation. The results of hierarchical regression analysis showed that depression was a significant predictor of suicidal thought. After controlling for the effects of demographic variables, resilience made a significant contribution in changing suicidal thought. This study also examined whether resilience moderates the effects of depression on suicidal ideation. There was evidence in favor of the moderating roles of resilience. Implications of social work practices and social work policy for preventing suicide among mothers of children with disability will be discussed.

The relationship of frailty and disability with suicidal ideation in late life depression

Objectives Frailty and disability are commonly found in Late Life Depression (LLD) and have been associated with increased depression severity, health comorbidities and mortality. Additionally, physical frailty has been associated with suicide in later life, independent of presence of a mood disorder. The objective of our study was to assess the associations of physical frailty and functional disability with suicidal ideation, controlling for depression severity and demographic factors, in an older depressed sample. Methods This study used data from community-dwelling older adults with major depression. Eligible participants were ≥ 65 years old, completed measures of depression symptom severity (Hamilton Depression Rating Scale-24 item; HDRS-24), current suicidal ideation (Geriatric Suicide Ideation Scale; GSIS), and physical frailty/functional capacity measures. Results Participants were 88 older adults with a mean age of 71.5 (SD = 6.0) and 66% of the sample was female. Poorer performance on frailty measures of gait speed (B = .239, p = .003) and muscle weakness (B = −.218, p = .01) were significantly associated with higher levels of suicidal ideation, independent of depression severity and demographic factors. Functional disability was also significantly related to suicide ideation, specifically impairment in financial capacity (B = −.290, p = .008), social interaction (B = .408, p < .001), and communication skills (B = .373, p = .001). Conclusion Our findings show that, in LLD, frailty and functional disability are significantly associated with higher levels of suicide ideation, independent of depression symptom severity.

A Brief Report on Suicidal Ideation in Adolescents Diagnosed with Asperger Syndrome

A limited number of studies have examined the intersection of suicide and autism spectrum disorders (ASD). Because of the limited data on suicidal ideation among individuals diagnosed with autism spectrum disorders, the objectives of this study were to measure the prevalence of suicidal ideation among adolescents diagnosed with Asperger syndrome and to assess the presence of mental health conditions in this population. This study examined the relationship between Asperger syndrome (AS) and suicidal ideation in a sample of 14 adolescents who completed an online survey. Participants completed an online survey using Qualtrics platform. This was a non-probability and purposive sample to assess the objectives. Several mental health measurements were used to assess for suicidal ideation and mental health. Of the 14 individuals, 21.4% (3) reported on high levels of suicidal ideation, and 28.6% (4) met the criteria for major depressive disorder while 15.4% (2) met the criteria for generalized anxiety disorder (GAD). Results suggested that suicidal ideations were correlated with peer victimization. The scores of suicidal ideations of individuals with MDD were higher compared with those who did not meet criteria for MDD. Future studies can enhance our understanding of risk for suicide among adolescents with AS. Data from this study is consistent with previous studies in the area. Educators, mental health professional, teachers, and parents should be aware of how suicide and mental health issues may present among adolescents diagnosed with AS.

The risk-benefit ratio of studying psychiatric symptoms via daily diary methods

ABSTRACTEthics committee members and researchers have deliberated about the risk-benefit ratio of researching sensitive issues such as psychiatric symptoms. Although research has suggested that inquiring about psychiatric symptoms in research generally does not cause harm, these findings have primarily arisen from cross-sectional studies. We examined whether this generalized to repeated, daily assessments of psychiatric symptoms. We collected daily survey data on psychiatric symptoms over 90 days from a sample of 206 college students. A subset of the sample (n = 80) provided reactions to study participation administered on the 90th day. Individuals who did not complete the 90th day survey reported higher levels of suicidal ideation and hopelessness than those who did. For individuals who completed the 90th, final assessment, reactions primarily fell within the neutral to positive range, with variation depending on their baseline levels of psychiatric symptoms and identification as religious. This study adds to past work by demonstrating that individuals who remained in the study had neutral to positive experiences. However, participants with greater suicidal ideation and hopelessness were likely to attrit, warranting caution in assuming a low risk-benefit ratio of these studies. Management of risks involved in repeated assessment studies may be informed by this work.

It\u2019s the thought that counts: belief in suicide as an escape moderates the relationship between emotion dysregulation and suicidal ideation cross-sectionally and longitudinally

BackgroundPrevious research has illustrated a relationship between emotion dysregulation and suicidal ideation, both cross-sectionally and longitudinally. However, it is not yet understood how this relationship manifests. The aim of this study was to explore if two beliefs about suicide, (1) suicide as a way to escape from emotional pain and (2) suicide as a solution to a problem, moderate the relationship between emotion dysregulation and suicidal ideation.MethodsOne hundred one community participants completed questionnaires examining emotion dysregulation, suicidal ideation, and beliefs in the functions of suicide. Inclusion criteria were used to over-sample individuals within the community experiencing higher levels of suicidal ideation and emotion dysregulation. Hierarchical linear regressions with interaction terms were used to assess moderation effects. The moderating role of beliefs in the function of suicide was examined both cross-sectionally and longitudinally.ResultsSuicide as an escape significantly moderated the relationship between global emotion dysregulation and suicidal ideation cross-sectionally, while it moderated the relationship between a facet of emotion dysregulation and suicidal ideation longitudinally. Greater endorsement of this belief resulted in a stronger relationship between emotion dysregulation and suicidal ideation. The function of suicide as a solution to a problem did not moderate the emotion dysregulation-suicidal ideation relationship.ConclusionsThese findings underscore the importance of not only addressing emotion dysregulation but also addressing the underlying belief that suicide is an escape in individuals who experience both emotion dysregulation and suicidal ideation. Intervention efforts to address belief in suicide as an escape along with emotion dysregulation are delineated.

Sexual orientation differences in non-suicidal self-injury, suicidality, and psychosocial factors among an inpatient psychiatric sample of adolescents

Within broader community samples, sexual minority adolescents (SMA, e.g., lesbian, gay, bisexual, queer) are at greater risk than their heterosexual counterparts for nonsuicidal self-injury (NSSI) and suicidal thoughts and behaviors. The present study investigated whether sexual minority orientation continues to confer additional risk for these behaviors in an already higher-risk sample of youth. Frequency and function of NSSI, suicidal behavior, and psychosocial factors were assessed in a sample of 52 adolescents (aged 12–18 years) admitted to an inpatient psychiatric unit due to suicide risk; 27 of them identified as SMA, and 25 as heterosexual (HA). Greater proportions of SMA reported engaging in lifetime NSSI, compared to HA, with a greater variety and frequency of NSSI behaviors and greater endorsement of intrapersonal NSSI functions. SMA reported higher levels of suicide ideation than HA, but not suicidal behavior. Group differences in NSSI and SI persisted when controlling for the greater prevalence of abuse and levels of peer-victimization reported by SMA. In inpatient clinical settings, SMA may be more likely than heterosexual youth to engage in NSSI, including more severe forms, and to experience suicide ideation. Providing alternative coping mechanisms may serve as treatment goals for reducing NSSI in SMA.

Trajectories of Suicidal Ideation During 12 Weeks of Escitalopram or Nortriptyline Antidepressant Treatment Among 811 Patients With Major Depressive Disorder.

Suicidal ideation is a frequent and difficult-to-treat clinical challenge among patients with major depressive disorder (MDD). However, little is known regarding the differential development during antidepressant treatment and whether some patients may suffer from persistent suicidal ideation. Among 811 patients with Schedules for Clinical Assessment in Neuropsychiatry (SCAN)-verified MDD from 2004-2007 assessed weekly for 12 weeks of escitalopram or nortriptyline antidepressant treatment, we applied item response theory to integrate a suicidality score based on 3 rating scales. We performed latent growth mixture modeling analysis to empirically identify trajectories. Multinomial logistic regression analyses estimated associations with potential predictors. We identified 5 distinct classes of suicidal ideation. The Persistent-low class (53.7%) showed no suicidal ideation whereas the Persistent-high class (9.8%) had high suicidal ideation throughout 12 weeks. Two classes showed a fluctuating course: the Fluctuating class (5.2%) ended at a low level of suicidal ideation, whereas the Slow-response-relapse class (4.8%) initially responded slowly but then experienced a large increase to a high level of suicidal ideation after 12 weeks. The Fast-response class (26.5%) had a high baseline severity similar to the Persistent-high class but responded quickly within a few weeks and remained at a low level. Previous suicide attempts and higher mood symptom severity were associated with worse suicidal ideation trajectories, whereas living with a partner showed a trend toward better response. Approximately 1 of 5 patients with MDD showed high or fluctuating suicidal ideation despite antidepressant treatment. Studies should investigate whether suicidal ideation may persist for longer periods and more targeted treatment possibilities. ISRCTN​​ identifier: ISRCTN03693000​​​​.

Suicidal ideation and behaviour in patients with persecutory delusions: Prevalence, symptom associations, and psychological correlates

BackgroundTo determine the prevalence of suicidal ideation and behaviour - and their correlates - in patients with persecutory delusions. Methods110 patients with persecutory delusions in the context of non-affective psychosis were assessed for suicidal thoughts and behaviours over the past month. Symptom and psychological assessments were also completed. ResultsThe severity of suicidal ideation was: no suicidal ideation (n = 26, 23.6%); wish to be dead (n = 21, 19.1%); nonspecific active suicidal thoughts (n = 14, 12.7%); suicidal thoughts with methods but no intent (n = 29, 26.4%); suicidal thoughts with intent but no specific plan (n = 13, 11.8%); and suicidal intent with plan (n = 7, 6.4%). In the past month, five patients (4.5%) had made an actual, interrupted, or aborted suicide attempt. The severity of suicidal ideation was associated with higher levels of depression, paranoia, hallucinations, anger, insomnia, negative beliefs about the self and others, pessimism, worry, and delusion safety-seeking behaviours and lower levels of psychological well-being and reward responsiveness. Severity of ideation was not associated with cannabis or alcohol use, working memory, pain, or meaningful activity levels. ConclusionsPatients with persecutory delusions are typically in a severe state of psychological stress, and at risk of suicide, as indicated by very high levels of suicidal ideation. This exploratory study also identifies correlates of suicidal ideation that could be investigated in causal research designs.

The online treatment of suicidal ideation: A randomised controlled trial of an unguided web-based intervention

Suicide is a major public health issue, and treatment of suicidal thoughts may contribute to its prevention. Provision of online treatment of suicidal ideation may reduce barriers that suicidal individuals experience in face-to-face treatment. We therefore aimed at evaluating the effectiveness of a web-based intervention targeting a reduction of suicidal ideation. We carried out a two-arm, parallel-design, randomised controlled trial in the general population in Flanders (Belgium) (registered as NCT03209544). Participants who were 18 years or older and experienced suicidal ideation were included. The intervention group (n = 365) received access to the unguided web-based intervention, and the control group (n = 359) was placed on a waitlist. Assessments were carried out at baseline and at 6 and 12 weeks. Participants reported high levels of suicidal ideation, depression, hopelessness, worrying, and anxiety at baseline. Compared to the control group, participants in the intervention group experienced a significant decline in suicidal ideation, depression, hopelessness, worrying, and anxiety both at post-test and at follow-up. An important limitation of the study was a high dropout rate, in particular in the intervention group. Our findings suggest that the online self-help intervention was more effective in reducing suicidal ideation and suicide-related symptoms than a waitlist control in a severely affected population. It can help in filling the gap between crisis help and face-to-face treatment.

Childhood Neglect and Adolescent Suicidal Ideation: a Moderated Mediation Model of Hope and Depression.

Using data collected on a two-wave longitudinal sample of 910 adolescents with mean age of 13.68years in Hong Kong, China, this survey aimed to test a moderated mediation model to account for the developmental pathway from childhood experiences of neglect to suicidal ideation in adolescents. Results showed that adolescents who were neglected as children had higher levels of suicidal ideation; furthermore, this relation was mediated by adolescents' depressive symptoms, while the path between adolescents' depressive symptoms and suicidal ideation was moderated by adolescents' sense of hope. Findings of this study imply that intervention and services that help prevent childhood neglect, alleviate depression, and promote hope are potentially important to decrease adolescent suicidal ideation.

Gender inequality and adolescent suicide ideation across Africa, Asia, the South Pacific and Latin America – a cross-sectional study based on the Global School Health Survey (GSHS)

ABSTRACTBackground: Suicide ideation is a health issue affecting adolescents worldwide. There are significant variations in suicide ideation between countries and genders, which have not been fully explained. Research is especially lacking in countries outside Europe and North America. Gender equality has been shown to matter in other aspects of adolescent mental health, such as life satisfaction, but has not been researched in relation to suicide ideation at national level.Objective: To investigate how national gender inequality is related to self-reported suicide ideation among adolescents, and whether this association differs between boys and girls.Methods: This is a cross-national, cross-sectional study using individual survey data from the Global School-based Student Health Survey, a survey in Africa, Asia, Latin America and the South Pacific, developed and supported by among others the WHO and the CDC; connecting this to national data: the gender inequality index from the UNDP; controlling for GDP per capita and secondary school enrolment. The data was analysed using a multilevel logistic regression method and included 149,306 students from 37 countries.Results: Higher national gender inequality, as measured by the gender inequality index, was significantly associated with a higher likelihood of suicide ideation in both girls and boys (odds ratio: 1.38 p-value: 0.015), but for girls and both sexes this was only after adjusting for selection bias due to secondary school enrolment (as well as GDP/capita). Interaction models showed that this association was stronger in boys than in girls.Conclusions: National gender inequality seems to be associated with higher levels of suicide ideation among adolescents in mainly low- and middle-income countries, especially among boys.

Suicidal ideation and suicide attempts in persons with gender dysphoria.

The little research there is about suicidal behaviour in those with gender dysphoria indicates that they are at a much higher risk of death by suicide and suicidal behaviour than the general population. The objective of this research is to analyse the prevalence of suicidal ideation and suicide attempts reported by people who attended consultations at the Gender Identity Treatment Unit between 2007 and 2017 presenting complaints related to gender dysphoria. An ex-post facto study with a sample of 151 people who were clients at the unit, 97 in the male to female trans group, 54 female to male. Clinical evaluations were carried out assessing variables of suicidal ideation and attempts, along with a possible psychiatric diagnosis. Almost half (48.3%) reported suicidal ideation, 23.8% had attempted suicide. There are higher levels of suicidal ideation and suicide attempts in people with gender dysphoria than in the general population. No differences were seen between groups in terms of gender/sex. Psychiatric morbidity was not an influential variable for suicidal behaviour. This suggests that suicidal ideation is one of the best indicators of the risk of suicidal behaviours.

Investigating The Exhaustion of Police officers, Selected Regions Within Namibia

Recent studies showed that suicide among police officers are prevalent in certain countries . Burnout and subjective health complaints are considered as risks that are consistent with high levels of suicide ideation. Police officers are exposed to life-threatening traumatic experiences, such as physical assault or witnessing disturbing images of death. The aim of this study was to investigate the relationship between job demands- resources, authentic leadership, work engagement and burnout within the Namibian Police Force. A cross - sectional survey design was used collecting data about police officers in the Erongo, Oshana and Khomas regions (n=369). Data was analysed using SPPS (version, 24) and Pearson product correlations. Results indicated that when police officers experience high a workload and leaders who do not engage in the moral and ethical behaviour, they will experience higher levels of exhaustion. Factors like organisational support and resources also seemed to impact on work engagement. To reduce exhaustion and increase engagement, it is vital that the police force assesses person-job fit, implement stress management and wellness programmes to help employees cope better with work demands. Moral and ethical behaviour can be enhanced through leadership training/development. Improving on colleague relations (team building) and through mentorship programmes employees would have access to social support at work, buffering a high workload.

A comparison of LGBTQ youth and heterosexual youth in the child welfare system: Mental health and substance abuse occurrence and outcomes

PurposeLGBTQ youth enter the child welfare system often because they are at higher risk of experiencing child maltreatment compared to youth who are heterosexual (Friedman, Marshal, Guadamuz, Wei, Wong, Saewye, & Stall, 2011), and due to family rejection, which places them at higher risk of suicide, higher levels of depression and are more likely to use substances (Ryan, Huebner, Dias & Sanchez, 2009). Using national data from the Substance Abuse and Mental Health Services Administration (SAMHSA), this study had two purposes; first to examine mental health disparities among LGBTQ youth and their heterosexual peers who are involved in the child welfare system, and second to observe the effectiveness of systems of care with youth in child welfare and if any differences exist between LGBTQ youth and heterosexual youth. MethodsChi-square and logistic regression were used to analyze differences at intake between youth who identified as LGBT or Q and their heterosexual counterparts. Repeated linear mixed modeling was used to evaluate the outcomes and to compare the groups at fixed time points (intake, 6-months, and 12-months). FindingsThe study found LGBTQ youth had higher levels of suicidal ideation, suicide attempts, depression, and gender identity related problems compared to the heterosexual youth in child welfare. All youth in the study experienced significant improvement, further supporting the effectiveness of system of care approaches. Recommendations are also discussed.

Psychosocial Factors Correlated with Undisclosed Suicide Attempts to Significant Others: Findings from the Adolescence SEYLE Study.

Suicide attempt (SA) is recognized as one of the risk factors for completed suicides. The concealment of this behavior often hinders detection and management of suicide risk. Thus, in this study, we sought to shed light on adolescents' psychosocial processes that could facilitate disclosure of SAs. Specifically, we sought to identify antecedents of adolescent SAs that had not been revealed to significant others. A high school sample) N=990 (completed a self-report questionnaire tapping psychiatric, personal, and interpersonal characteristics, as well as suicidality, as part of the SEYLE project. Twenty-seven adolescents acknowledged having made an SA without disclosing it to parents or to other significant others. They were compared with 47 adolescents who made SAs that were communicated to others and with a control group of 916 adolescents having no history of suicidal behavior. Compared with disclosures and controls, non-disclosing suicide attempters were characterized by higher levels of suicide ideation, distress, and victimization. Low levels of self-disclosure and parental support were significantly associated with undisclosed SAs. Interpersonal difficulties may be related to loneliness and a thwarted sense of belongingness, which may explain the failure to disclose SAs. Implications related to assessment and prevention are discussed.

The co-occurrence of autistic traits and borderline personality disorder traits is associated to increased suicidal ideation in nonclinical young adults

BackgroundThe co-occurrence of Autism Spectrum Disorder (ASD) and Borderline Personality Disorder (BPD) is not rare and has been linked to increased suicidality. Despite this significant comorbidity between ASD and BPD, no study had examined the co-occurrence of autistic traits and borderline personality disorder traits in the general population. The aim of the present study was to examine the co-occurrence of autistic and borderline traits in a non-clinical sample of young adults and its influence on the levels of suicidal ideation and depressive symptomatology. ProceduresParticipants were 474 college students who completed self-report questionnaires. Data were analysed using correlation and cluster analyses. Main findingsBorderline personality traits and autistic traits were weakly correlated. However, cluster analysis yielded four groups: a low traits group, a borderline traits group, an autistic traits group, and a group characterized by high levels of both traits. Cluster analysis revealed that autistic and borderline traits can co-occur in a significant proportion of young adults. The high autistic and borderline traits group constituted 17% of the total sample and had higher level of suicidal ideation than the borderline traits group, despite similar levels of depressive symptoms. ConclusionThis result suggests that the higher suicidality observed in patients with comorbid ASD and BPD may extent to non-clinical individuals with high levels of co-occurrent autistic and borderline traits.

Characteristics of Stress and Suicidal Ideation in the Disclosure of Sexual Orientation among Young French LGB Adults.

Background: Lesbians, gays, and bisexual people (LGB) present high levels of suicidal ideation. The disclosure of sexual orientation is a stressful experience which presents a high suicide risk. Research has not paid sufficient attention to stress during this disclosure in order to understand suicide among LGB people. The aims of this study were to investigate: (1) the characteristics of stress during this revelation, more precisely cognitive appraisal, emotions, and coping; and (2) associations between these characteristics and suicidal ideation. Method: A total of 200 LGB young adults answered the “Stressful situation assessment questionnaire”, focusing on the most stressful disclosure of sexual orientation they have ever experienced. Results: Avoidance coping is a good predictor of suicidal ideation, and mediates the association between primary appraisal (risk “Harm myself and others”) and suicidal ideation. Conclusions: Our study illustrates the need to better understand stress during the disclosure of sexual orientation to prevent and care for suicide risk among LGB young adults.

Sexual Identity, Adverse Childhood Experiences, and Suicidal Behaviors

PurposeThe objective of this study was to examine the influence of sexual identity and adverse childhood experiences (ACEs) on suicidal behaviors in a population-based sample of high school students. MethodsA two-stage cluster random sampling design was used to recruit 5,108 students from 97 high schools. A total of 4,955 students (97%) provided information that allowed for classification of sexual identity into three groups: (1) lesbian, gay, or bisexual (LGB) (10%); (2) not sure (4.6%); and (3) heterosexual (85.4%). Five measures of childhood abuse and household dysfunction were summed, and the ACE score was categorized as 0, 1, 2, and 3–5 ACEs. Weighted logistic regression was used to assess the influence of sexual identity, ACEs, and their interaction on suicide ideation and attempts in the past 12 months. ResultsCompared with heterosexual students, those who were LGB and were not sure had higher odds of suicide ideation and attempts. There was also a graded relationship between cumulative ACE exposure and suicidal behaviors. Although sexual identity/ACE interaction was not observed, LGB/not sure students who experienced a high number of ACEs were disproportionately affected. Compared with heterosexual students with 0 ACE, LGB/not sure students with 0 ACE (adjusted odds ratio [AOR] = 3.32, 95% confidence interval [CI] = 1.96–5.61), 1 ACE (AOR = 6.58, 95% CI = 4.05–10.71), 2 ACEs (AOR 13.50, 95% CI = 8.45–21.58), and 3–5 ACEs (AOR = 14.04, 95% CI = 8.72, 22.62) had higher odds of suicide ideation. A similar pattern was observed for suicide attempts. ConclusionsLGB and students not sure of their sexual identity with greater exposure to ACEs have disproportionately high levels of suicide ideation and attempts. Trauma-informed interventions for these populations are warranted.

Suicidality and Intersectionality Among Students Identifying as Nonheterosexual and With a Disability

Research about students with disabilities and students identifying as LGBQ (lesbian, gay, bisexual, or questioning) reveals that both populations report more suicidality and peer victimization and less school connectedness than do their peers. No study has previously examined the intersection of these identities with regard to peer victimization, school connectedness, and suicidality. Using a sample of 11,364 high school students, we examined the relationships among these identities, peer victimization, and school connectedness with suicidal ideation. Compared with their peers without either identity, students identifying with one of these identities reported higher levels of suicidal ideation. School connectedness and peer victimization each moderated the association between identity and suicidal ideation. In addition, students who were victimized more than their peers and who identified both with a disability and as LGBQ ( n = 250) reported the highest levels of suicidal ideation. School-based victimization and suicide prevention programs should consider students’ multiple identities.