Levels Of Suicide Risk Research Articles

Examining the relationship between religious volunteering and mental health screeners among firefighters

ABSTRACT Firefighters experience a high level of traumatic incidents in their work. This high level of exposure puts them at risk for trauma-related symptoms. These trauma symptoms include PTSD, suicide risk, alcohol misuse, and depression, and anxiety. Furthermore, repeated exposure has been found to lead to desensitization, flashbacks, irritability, and PTSD. Exposure to natural disasters may also impact ecospirituality. A survey was designed to include the Life Events Checklist, PHQ-9, GAD-7, PCL-5, and the SBQ-R. This survey was administered to firefighters from Northwest Florida in the fall of 2020 and spring of 2021. Participants were found to have higher levels of PTSD, anxiety, depression, and suicidal risk than the general population. Participants were further asked about their volunteering for religious organization activity. A significant relationship was found between volunteering for religious organization and mental health screeners. Religious volunteering predicted lower levels of PTSD symptoms, depression, and anxiety. The effect size was small.

Alpha oscillation mediates the interaction between suicide risk and symptom severity in Major Depressive Disorder.

The aim of our study was to explore the relationship between changes in neural oscillatory power in the EEG, the severity of depressive-anxiety symptoms, and the risk of suicide in MDD. 350 MDD patients' demographic and clinical data were collected, and their depressive and anxious symptoms were evaluated using HDRS-17 and HAMA-14, along with a suicide risk assessment using the Nurses' Global Assessment of Suicide Risk (NGASR). EEG data were captured, processed, and analyzed to study brain activity patterns related to MDD. The participants were divided based on suicide risk levels, and statistical analyses, including chi-square, t-tests, Pearson's correlations were used to explore the associations between brain activity, symptom severity, and suicide risk. Closely related variables were identified and ultimately the optimal model was screened using stepwise regression analysis with a forward strategy, and mediation effects were further used to determine the possible interactions between the variables in the regression model. The regression model showed a significant effect of HDRS-17 and alpha power of Medial Occipital Cortex (MOC) on suicide risk, with elevated HDRS-17 increasing suicide risk and elevated alpha power decreasing suicide risk. Mediation effect analyses showed that MOC alpha power partially mediated the effect of depression level on suicide risk, and that an increase in depression severity may lead to a decrease in MOC alpha power, while a decrease in MOC alpha power may lead to an increase in suicide risk. The severity of depression directly increases suicide risk, whereas higher alpha power in the MOC serves as a protective factor, reducing this risk. Notably, MOC alpha power not only directly impacts suicide risk but also mediates the effects of both depression severity and anxiety levels on this risk. The relatively small sample size of this study may limit the representativeness of the overall MDD patient population and the detailed analysis of different subgroups. This study did not delve into the relationship between the severity of cognitive symptoms in MDD patients and suicide risk.

Comparison of Acoustic Parameters of Voice and Speech According to Vowel Type and Suicidal Risk in Adolescents

Globally, suicide prevention and understanding suicidal behavior represent significant health challenges. The predictive potential of voice, speech, and language appears as a promising solution to the difficulty in assessment. ObjectiveTo analyze variations in acoustic parameters in voice and speech based on vowel types according to different levels of suicidal risk among adolescents in a text reading task. MethodologyCross-sectional analytical design using non-probabilistic sampling. Our sample comprised 98 adolescents aged 14 to 19, undergoing voice acoustic assessment, along with suicidal ideation determination through the Okasha Suicidality Scale and Beck Depression Inventory. Acoustic analysis of recordings was conducted using Praat for phonetic research, Python program, Focusrite interface, and microphone to register voice and speech acoustic parameters such as Fundamental Frequency, Jitter, and Formants. Subsequently, data from adolescents with and without suicidal risk were compared. ResultsSignificant differences were observed between suicidal and non-suicidal adolescents in several acoustic aspects, especially in females in fundamental frequency (F0), signal-to-noise ratio (HNRdB) and temporal variability measured by jitter and standard deviation. In mens, differences were found in F0 and HNRdB (p < 0.05). ConclusionThis study demonstrated statistically significant variations in various voice acoustic parameters among adolescents with and without suicidal risk. These findings underscore the potential relevance of voice and speech as markers for suicidal risk.

The Westerman Aboriginal Symptom Checklist – Youth Version: national data from a clinical sample of Aboriginal youth

ABSTRACT Objectives To produce national clinical norms for WASC-Y, examine the internal consistency of the WASC-Y scales, compare scores from a clinical sample with previously published community sample data, and test the degree to which other scales predict the Suicide Scale. Method We analysed WASC-Y data from 1226 Aboriginal youth who had presented to mental health services between 2007 and 2022 and compared their scores to the original community norms. Results Our sample shows a higher level of mental health risk than does the normative sample that varied according to gender. We found high levels of suicidal behaviour in the clinical sample: 41.5% admitted to thoughts of suicide and 25.0% reported one or more suicide attempts. One in 23 reported a high likelihood that they would attempt suicide again. Knowing someone who has suicided was associated with higher Suicide Risk. Linear modelling showed that Suicide Risk is predicted by a combination of all other WASC-Y scales and gender, with females at higher risk than males. There is emerging evidence that Cultural Resilience provides some mitigation of Suicide Risk. Conclusions Our data provide the first culturally and psychometrically valid national mental health profile of Aboriginal youth accessing mental health services, including separate clinical norms for males and females. Aboriginal youth present with serious levels of suicide and mental health risk that urgently require improved access to clinically and culturally competent services. Our findings provide evidence of construct validity, in that scale scores showed meaningful associations with each other and with other variables in expected ways.

Mindsets of suicide trajectories: An Linguistic Inquiry and Word Count analysis of suicide hotline conversations.

The aim of the study was to explore the psychological characteristics of the individuals with various suicide risks using computerized text analysis, in the hopes of a better understanding of suicide trajectories. 627 first-time callers' records were randomly selected from Taiwan An-Shin Hotline database between 2013 and 2018. The voice records were evaluated by two psychologists to determine the levels of suicide risk (156 with uncertainty of risk, 177 with low suicidal ideation, 157 with high suicidal ideation, and 137 with suicide preparation/attempt) and transcribed into text. The Linguistic Inquiry and Word Count 2015 (LIWC2015) program combined with Chinese dictionary were then used to calculate the frequency of word categories. Exploratory factor analysis identified four mindsets of language characteristics, named "opposition and questioning", "active engagement", "negative rumination", and "focus on death". Psychological descriptions of the mindsets were also obtained through correlation analysis with the LIWC2015 categories and indicators. The four mindsets effectively distinguished the callers with different levels of suicide risk. The psychological characteristics of people with various suicide risks can be described and differentiated via the closed-word categories and composite indicators. These results provide useful information for practitioners and researchers.

Factors associated with suicide risk and attempts in healthcare students: A cross-sectional study.

Suicide deaths in young people have been increasing in recent decades and are considered a major public health problem worldwide, being a partially preventable event. The prevalence of suicidal ideation is high among university students, especially in health careers. The objective of this study was to measure the prevalence of high suicidal risk in this specific group and to identify associated factors, aiming to provide empirical evidence for the construction of effective suicide prevention strategies. A cross-sectional study was conducted based on an online survey directed to healthcare students near the end of the first year of the COVID-19 pandemic to learn about the frequency of suicidal risk and its associated factors. The sample consisted of 477 students (70.8% female, mean age 21.7 ± 2.5 years) from eight healthcare majors. The data were collected in January 2021. 22.6% of the young people reported a high suicide risk on the Okasha scale, and 3.4% made a suicide attempt in the previous year. Factors associated with high suicidal risk were having a non-heterosexual orientation, an irregular academic trajectory, experiences of physical and/or psychological violence, higher levels of depressive and anxious symptomatology, as well as lower levels of social support from friends and family. Suicide risk and attempt levels are high in this group of students, and there is a group of factors that could guide more effective actions, such as support for higher-risk groups and screening to identify and provide support to young people at high suicidal risk and with mental health conditions.

Psychometric Properties of a Persian Version of the Columbia Suicide Severity Rating Scale (C-SSRS) in Iranian Soldiers.

Objective: Suicide is an important health issue nearly all over the world. The Columbia Suicide Severity Rating Scale (C-SSRS) is a well-known instrument for suicide risk assessment. Our purpose in this study is to provide a Persian version of the C-SSRS and evaluate its psychometric properties in the Iranian military population, particularly suicide risk leveling characteristic of the C-SSRS. Method : For linguistic adaptation, we gathered opinions of an expert panel consisting of 23 professionals in mental health sciences. Furthermore, this version was administered to two groups of soldiers, one representing a sample of normal population (N = 338), while the other group comprised a sample of clinical population from a referral psychiatric hospital (N = 348) in Tehran, capital of Iran, from July 2021 until one year later. Besides the C-SSRS, the Beck Scale for Suicidal Ideation (BSSI), Beck Hopelessness Scale (BSS), and General Health Questionnaire 28 (GHQ28) were obtained from the participants. Correlation coefficients, internal consistency, and factor analysis were evaluated using the Statistical Package for the Social Sciences (version 23) software. Results: All items of the Persian version of the C-SSRS had acceptable content validity and face validity. This tool demonstrated high correlation coefficients with the BSSI (r = 0.73, P < 0.001) and BHS (r = 0.64, P < 0.001), but a low correlation coefficient with the GHQ28 (r = 0.22, P < 0.001). Specifically, the suicide risk level based on the C-SSRS had a high correlation with both the BSSI and BHS. Also, its internal consistency was satisfactory (Cronbach's alpha = 0.89). Furthermore, factor analysis revealed two factors that is consistent with suicidal ideation and suicidal behavior factors. Conclusion: Our results indicated acceptable validity and reliability for the Persian version of the C-SSRS, demonstrating its capability to classify suicide risk. It can be concluded that the ordinal suicide risk level (as red, orange, yellow and green) is a valid index for the application of the C-SSRS.

Suicidal Ideation Status and Its Related Factors Among Older Adults in Yazd, Iran

Objectives: To assess the prevalence of suicidal ideation and identify the factors associated with it among the elderly population in Yazd during the year 2021. Design: A cross-sectional study. Setting(s): Tabriz, the capital city of the East Azerbaijan province in northwestern Iran. Participants: A total of 386 seniors aged 60 years and above, residing in Yazd, participated in this study. The sample consisted of 212 women and 174 men selected using the cluster random sampling method. Outcome measures: Data were collected via the Beck Scale for Suicide Ideation (BSSI). Results: Five percent of the participants have a high level of suicidal risk and readiness for suicide. Additionally, the mean score of suicidal ideation varied significantly based on demographic variables such as gender, occupation, education level, and income type (P &lt; 0.05). Moreover, the risk of suicidal ideation was higher among women compared to men, particularly among housekeepers compared to other occupational groups (P &lt; 0.05). Furthermore, elderly individuals who relied on support from their children and other supportive institutions as their source of income were more susceptible to suicidal ideation compared to others (P &lt; 0.05). In terms of education, elderly individuals with no education or only primary education had a higher risk of suicidal ideation compared to those with a high school diploma or higher education (P&lt;0.05). In addition, individuals with a history of psychiatric disorders, musculoskeletal diseases, high blood pressure, comorbidity, and high cholesterol levels obtained significantly higher scores for suicidal ideation compared to elderly individuals without these conditions (P&lt;0.05). Conclusions: The elderly individuals in Yazd exhibited a desirable level of suicidal ideation, with a low risk of suicide. However, the risk factors for suicidal ideation examined in this study highlight the need for increased attention by healthcare managers to the mental health of the elderly population.

Tracking and Profiling Repeated Users Over Time in Text-Based Counseling: Longitudinal Observational Study With Hierarchical Clustering.

Due to their accessibility and anonymity, web-based counseling services are expanding at an unprecedented rate. One of the most prominent challenges such services face is repeated users, who represent a small fraction of total users but consume significant resources by continually returning to the system and reiterating the same narrative and issues. A deeper understanding of repeated users and tailoring interventions may help improve service efficiency and effectiveness. Previous studies on repeated users were mainly on telephone counseling, and the classification of repeated users tended to be arbitrary and failed to capture the heterogeneity in this group of users. In this study, we aimed to develop a systematic method to profile repeated users and to understand what drives their use of the service. By doing so, we aimed to provide insight and practical implications that can inform the provision of service catering to different types of users and improve service effectiveness. We extracted session data from 29,400 users from a free 24/7 web-based counseling service from 2018 to 2021. To systematically investigate the heterogeneity of repeated users, hierarchical clustering was used to classify the users based on 3 indicators of service use behaviors, including the duration of their user journey, use frequency, and intensity. We then compared the psychological profile of the identified subgroups including their suicide risks and primary concerns to gain insights into the factors driving their patterns of service use. Three clusters of repeated users with clear psychological profiles were detected: episodic, intermittent, and persistent-intensive users. Generally, compared with one-time users, repeated users showed higher suicide risks and more complicated backgrounds, including more severe presenting issues such as suicide or self-harm, bullying, and addictive behaviors. Higher frequency and intensity of service use were also associated with elevated suicide risk levels and a higher proportion of users citing mental disorders as their primary concerns. This study presents a systematic method of identifying and classifying repeated users in web-based counseling services. The proposed bottom-up clustering method identified 3 subgroups of repeated users with distinct service behaviors and psychological profiles. The findings can facilitate frontline personnel in delivering more efficient interventions and the proposed method can also be meaningful to a wider range of services in improving service provision, resource allocation, and service effectiveness.

ОСОБЛИВОСТІ ВЗАЄМОЗВ’ЯЗКУ РІВНЯ СУЇЦИДАЛЬНОГО РИЗИКУ ТА ЕМОЦІЙНОГО ВИГОРАННЯ У ВІЙСЬКОВОСЛУЖБОВЦІВ

The article presents the results of a theoretical analysis and an empirical study of the features of the relationship between emotional burnout and suicidal risk in military personnel. The analysis of the psychological literature on the problem showed that the activities of the military take place in special, extreme conditions associated with a threat to people’s lives and health. It makes higher demands on the personality of the military man, his moral-willed, emotional, intellectual qualities, which creates an increased load on the specialist’s adaptive systems. Over time, there is an accumulation of negative states, which leads to the development of various professional deformations and destructions. One of the manifestations is the syndrome of emotional burnout, the consequence of which can be the appearance of suicidal thoughts and behavior. The purpose of the study is to determine the characteristics of the relationship between emotional burnout and suicidal risk in military personnel. Scientific novelty. The conducted research revealed that all symptoms of emotional burnout in military personnel are in the stage of formation. Among suicidal motivation, the most pronounced complexes are: anesthetic, anemic, altruistic and autopunitive. The least pronounced are instrumental and heteropunitic. The most pronounced anti-suicidal motivational complexes are: final uncertainty, ethical complex, moral and salutary. The least expressed are aesthetic, narcissistic and religious. The most pronounced diagnostic concepts of suicidal risk are: anti-suicidal factor, demonstrativeness, social pessimism and maximalism. The least pronounced is the breaking of cultural barriers. Conclusions. The analysis of the features of the relationship between emotional burnout and suicidal risk showed that the formation of emotional burnout syndrome significantly increases the level of suicidal risk in military personnel. Psychologists need to develop effective means of preventing emotional burnout in military personnel. Key words: emotional burnout, autoaggressive behavior, suicidal behavior, military personnel.

Assessment of Suicide Risk in Patients with Depressive Episodes Due to Affective Disorders and Borderline Personality Disorder: A Pilot Comparative Study.

This study assessed suicidal risk in patients suffering from non-psychotic depressive disorders within various clinical and nosological forms (F31-F34 mood disorders and F60.31-emotionally unstable personality disorder). Clinical and psychological features were presented, as well as predictors of suicidal risk in patients of these groups. We performed a comparative analysis of the anxiety and depression level, the level of mental pain, fear of death and the severity of anti-suicidal motives in patients with affective disorders and borderline personality disorder (BPD). Based on the results, 100% of patients in these clinical nosological groups were found to have a high level of suicidal risk. Patients with affective disorders have weak anti-suicidal motives and are not fully aware of the consequences of their own death. Patients with BPD have a higher suicidal risk than patients with affective disorders; they are characterized by less pronounced social orientation, demonstrativeness, self-centeredness, less pronounced levels of anxiety and fear of death.

Influences of sleep, cortisol reactivity, and risk/reward-based decision-making on suicide

Background and objectivesPoor sleep quality is a known contributor to suicidal thoughts and behaviors. This study examines whether sleep quality modulates the effect of an individual's stress response and risk/reward-based decision making on suicide risk. MethodsParticipants were 160 adults at a residential substance use treatment facility with lifetime exposure to trauma who completed a clinician-administered measure of suicide risk, the Iowa Gambling Task (IGT), and a self-report measure of sleep. Cortisol reactivity (i.e., changes in cortisol before and after a personalized trauma script) was used to measure stress response. We used quantile regression to examine the effects of sleep, cortisol, and risk/reward decision-making on suicide risk. ResultsWe found poor sleep quality to be increasingly salient in individuals at greater risk for suicide than those at lower risk for suicide. Furthermore, individuals with moderate to moderate-high levels of suicide risk seem to have greater cortisol reactivity. In the low-moderate quantile, we found suicide risk to be associated with both high stress reactivity and low-risk, high-reward decision-making, as well as low stress reactivity and high-risk/low-reward decision-making. LimitationsThese findings should be interpreted considering several methodological constraints, such as the use of a pre-determined sample and instruments not tailored for our hypotheses, the MINI ‘Suicide’ Module's limited differentiation between suicidal ideation and behavior, and variably timed cortisol sampling. ConclusionsDespite these limitations, the findings from this study support the use of evidence-based interventions focused on improving sleep quality and managing emotional reactivity to decrease suicide risk.

Clinical, behavioral, and electrophysiological profiles along a continuum of suicide risk: evidence from an implicit association task.

An urgent need exists to identify neural correlates associated with differing levels of suicide risk and develop novel, rapid-acting therapeutics to modulate activity within these neural networks. Electrophysiological correlates of suicide were evaluated using magnetoencephalography (MEG) in 75 adults with differing levels of suicide risk. During MEG scanning, participants completed a modified Life-Death Implicit Association Task. MEG data were source-localized in the gamma (30-58 Hz) frequency, a proxy measure of excitation-inhibition balance. Dynamic causal modeling was used to evaluate differences in connectivity estimates between risk groups. A proof-of-concept, open-label, pilot study of five high risk participants examined changes in gamma power after administration of ketamine (0.5 mg/kg), an NMDAR antagonist with rapid anti-suicide ideation effects. Implicit self-associations with death were stronger in the highest suicide risk group relative to all other groups, which did not differ from each other. Higher gamma power for self-death compared to self-life associations was found in the orbitofrontal cortex for the highest risk group and the insula and posterior cingulate cortex for the lowest risk group. Connectivity estimates between these regions differentiated the highest risk group from the full sample. Implicit associations with death were not affected by ketamine, but enhanced gamma power was found for self-death associations in the left insula post-ketamine compared to baseline. Differential implicit cognitive processing of life and death appears to be linked to suicide risk, highlighting the need for objective measures of suicidal states. Pharmacotherapies that modulate gamma activity, particularly in the insula, may help mitigate risk.Clinicaltrials.gov identifier: NCT02543983, NCT00397111.

Identification of factors associated with suicidal behavior in Colombian indigenous children and adolescents

Suicide among indigenous children and adolescents poses a particularly challenging public health issue for Western healthcare systems. The aim of this study was to identify psychological factors and parent/caregiver attachment-related factors associated with suicide risk in indigenous children and adolescents. A correlational cross-sectional study was conducted, involving 399 children and adolescents and their families from four indigenous communities, with a mean age of 11.93 years. 89% of children and adolescents were found to have some level of self-reported suicide risk, with parents identifying this risk in 21.1% of children and youth. The risk was found to be associated with perceived criticism by caregivers, the use of physical punishment, and the identification of feelings of worthlessness. In addition to highlighting high indicators of suicide risk in the studied population, this study concludes that indicators of distress in children and adolescents are associated with disruptions in the perception of relationships with their parents.

Evaluation of the Effectiveness of Suicide.ca, Quebec's Digital Suicide Prevention Strategy Platform: Cross-Sectional Descriptive Study.

In 2017, the Quebec government assigned the Association québécoise de prévention du suicide (AQPS) to develop a digital suicide prevention strategy (DSPS). The AQPS responded by creating a centralized website that provides information on suicide and mental health, identifies at-risk individuals on the internet, and offers direct crisis intervention support via chat and text. This study aims to evaluate the effectiveness of suicide.ca, Quebec's DSPS platform. This study used a cross-sectional descriptive design. The study population comprised internet users from Quebec, Canada, who visited the suicide.ca platform between October 2020 and October 2021. Various data sources, such as Google Analytics, Firebase Console, and Customer Relation Management data, were analyzed to document the use of the platform. To understand the profile of suicide.ca users, frequency analyses were conducted using data from the self-assessment module questionnaires, the intervention service's triage questionnaire, and the counselors' intervention reports. The effectiveness of the platform's promotional activities on social media was assessed by examining traffic peaks. Google Analytics was used to evaluate the effectiveness of AQPS' strategy for identifying at-risk internet users. The impact of the intervention service was evaluated through an analysis of counselors' intervention reports and postintervention survey results. The platform received traffic from a diverse range of sources, with promotional efforts on social media directly contributing to the increased traffic. The requirement of a user account posed a barrier to the use of the mobile app, and a triage question that involved personal information led to a substantial number of dropouts during the intervention service triage. AdWords campaigns and fact sheets addressing suicide risk factors played a crucial role in driving traffic to the platform. With regard to the profile of suicide.ca users, the findings revealed that the platform engaged individuals with diverse levels of suicidal risk. Notably, users of the chat service displayed a higher suicide risk than those who used the self-assessment module. Crisis chat counselors reported a positive impact on approximately half of the contacts, and overall, intervention service users expressed satisfaction with the support they received. A centralized digital platform can be used to implement a DSPS, effectively reaching the general population, individuals with risk factors for suicide, and those facing suicidal issues.

НЕКОТОРЫЕ ВОПРОСЫ ПСИХОЛОГИЧЕСКОЙ РАБОТЫ С ЭМОЦИОНАЛЬНОЙ СФЕРОЙ ОСУЖДЕННЫХ, СКЛОННЫХ К СУИЦИДУ

The article discusses the possible causes of the formation of suicidal manifestations in persons in conditions of social isolation. The statistical data of the Federal Penitentiary Service of Russia are presented, indicating the importance and timeliness of solving penitentiary tasks related to the identification of suicidal intentions in convicts, as well as actual factors of suicidal risk. It is proposed to discuss the problem of the influence of the emotional sphere of the individual on the commission of suicidal acts, taking into account the specific circumstances of serving a criminal sentence. The results of an empirical study of the emotional sphere of convicts with autoaggressive behavior using valid psychodiagnostic tools are presented. The conclusion is formulated that the instability of the emotional properties of the individual affects the increase in the level of suicidal risk. The importance of conducting comprehensive psychological work with suicidal convicts in institutions executing criminal penalties is emphasized. The question is raised about the need to improve the professional competencies of the staff of the penitentiary system to reduce the risk of suicide and improve the mental state of convicts

Adult female callers’ characteristics and mental health status: a retrospective study based on the psychological assistance hotline in Hangzhou

ObjectiveThis study aims to analyze the basic characteristics and mental health status of adult female callers to the psychological assistance helpline in Hangzhou City, in order to provide targeted services for effectively intervening in the psychological crises of this group.MethodsData from adult female callers to a helpline in Hangzhou City were collected between 2019 and 2022, encompassing demographic information and discussed issues. The data were analyzed according to age groups, marital status, and call times. The mental health status of the adult female population was measured by two indicators—mood status and suicide risk.ResultsThe study included 15,580 adult female callers. Among them, 52.2% were aged 30 and below, 62.1% were unmarried, and 42.6% were from other provinces. The primary types of calls were related to mental health (56.5%), romantic relationships (11%), and marriage/family issues (13%). Adults aged 30 and below had more consultations about romantic relationships, work, and study-related issues compared to those over 30. Those over 30 sought more advice on marriage/family and child education. Younger callers displayed higher levels of depression and suicide risk compared to older callers. Unmarried callers had a higher proportion of moderate depression and suicide risk than married callers. Higher education levels were associated with lower depression levels (OR = 0.631,95%CI:0.439–0.906, P = 0.013) and high-risk proportions (OR = 0.328,95%CI:0.147–0.733, P = 0.007). Late evening callers had a higher high-risk proportion (OR = 5.326,95%CI:2.633–10.775, P < 0.001), and employed individuals had lower high-risk proportions compared to unemployed callers (OR = 0.536,95%CI:0.320–0.897, P = 0.018).ConclusionThe mental health status of female callers aged 30 and below, unemployed individuals, and those calling in the latter part of the night have relatively poorer mental health and are more likely to be at risk for suicide, which needs to be taken seriously, and more professional and targeted intervention services need to be enhanced in the hotline.

Rapid screening for suicide risk: An algorithmic approach.

In the United States, primary medical care settings are the first accessed resource for both medical and behavioral health care. Thus, there is a clear need for accurate and efficient behavioral health screening in this setting, including routine surveillance screening for suicide risk. The Multidimensional Behavioral Health Screen (MBHS), a broadband but very brief screening tool developed specifically for primary care, has been updated to include an algorithm that classifies suicide risk based on the interpersonal-psychological theory of suicide, and associated interview and decision framework. This study aims to evaluate the predictive accuracy of the new MBHS 2.0 suicide risk algorithm, with actual risk determined by clinical suicide risk interview. Data were collected as part of a larger study that, overall, included 551 college student participants. Of these, 309 completed the MBHS 2.0 and the clinical suicide risk interview, the two measures reported here. The final participant count was 299 following the removal of incomplete or invalid cases. Predicted suicide risk as determined by the MBHS 2.0 (Low, Mild, At least Moderate) was compared to actual risk as determined by clinical interview (Low, Moderate, Severe, Extreme). Utilizing chi-square analyses, data show a significant association between the predicted suicide risk category based on the MBHS 2.0 algorithm and the actual risk category based on the semi-structured clinical interview. Furthermore, classification analyses suggest that primary care providers will be able to confidently assess the suicide risk level for the majority of their patients when using the MBHS. Findings suggest that the MBHS 2.0 can be an accurate and efficient tool for use by primary care providers in classifying suicide risk. Future research will be useful to evaluate the utility of the suicide risk algorithm among primary care populations.

Aggressive behaviour and suicidal concerns during remand imprisonment and the relation to mental health(care)

ABSTRACT Prisoners display high levels of suicide risk and aggression and prisoners report unmet needs. The relation to mental healthcare is unclear. The current study analysed 226 prisoners on aggressive behaviour and suicidal concerns during general remand imprisonment in the Netherlands, in relation to mental health(care). Aggressive behaviour and suicidal concerns were assessed every four weeks during the first four months of remand imprisonment by the Social Dysfunction and Aggression Scale and Brief Psychiatric Rating Scale. Psychiatric disorders (Mini International Neuropsychiatric Interview – Plus) and unmet needs (Camberwell Assessment of Needs – Forensic Version) were assessed as was provided mental healthcare during imprisonment. The levels of aggressive behaviour and suicidal concern were consistent over time and overall displayed by 18% and 15% of the prisoners, respectively. Aggressive behaviour appeared related to psychiatric symptoms and prior mental health treatment, as was suicidal concern. However, in contrast to individuals with suicidal concerns, prisoners with aggressive behaviour less often received mental healthcare in prison. This appears to be related to the finding that aggressive prisoners do not report more unmet needs compared to non-aggressive prisoners. In conclusion, aggressive behaviour is more strongly related to mental health than might be expected. Prisontime perhaps could initiate mental healthcare.

Initial validation of the International Trauma Questionnaire (ITQ) in a sample of Chilean adults

ABSTRACT Background: ICD-11 Posttraumatic Stress Disorder (PTSD) and Complex PTSD (CPTSD) are stress-related disorders. The International Trauma Questionnaire (ITQ) is a widely used instrument to assess PTSD and CPTSD. To date, there is no evidence of the psychometric characteristics of the ITQ in Latin American countries. Objective: The aim of this study was to assess the construct and concurrent validity of the Latin American Spanish adaptation of the ITQ in a sample of Chilean adults. Methods: A sample of 275 Chilean young adults completed the ITQ, a traumatic life events checklist, the Adverse Childhood Experiences Questionnaire, the Depression Anxiety Stress Scales-21, and the Columbia-Suicide Severity Rating Scale short version. Four alternative confirmatory factor analysis models were tested. Correlation analyses were performed to determine concurrent validity with associated measures (number of reported traumatic events, number of adverse childhood experiences, anxiety, depression, and suicidal risk). Results: The second-order two-factor (PTSD and DSO) and the correlated first-order six-factor model provided acceptable fit; however, the first model showed a better fit based on the BIC difference. The PTSD and DSO dimensions, as well as the six ITQ clusters showed positive correlations with reported number of traumatic life-events, reported number of adverse childhood experiences, levels of anxiety, depression, and suicidal risk. Conclusions: The ITQ Latin American Spanish adaptation provides acceptable psychometric evidence to assess PTSD and CPTSD in accordance with the ICD-11.