Lifetime Suicidal Ideation Research Articles

Thinking About Suicidal Thinking: Suicide-Related Metacognitions’ Relation to Maladaptive Processing of Suicidal Thoughts

Abstract Objective The metacognitive model of suicidality proposes that positive metacognitions about suicide (PMS) activate a cognitive attentional syndrome (CAS), i.e., suicide-specific rumination, attentional fixation, and thought suppression, which in turn activates negative metacognitions about suicide (NMS) and an aggravation of suicidality. Preliminary evidence supports the model assumptions; however, a more comprehensive investigation is missing by now. Methods One hundred eighty-six participants (148 female [79.6%]; age M = 28.3 (SD = 9.8)) with lifetime suicidal ideation filled in self-report measures of suicide ideation/behavior, all CAS-components, and metacognitions about suicide. Results All elements of the CAS correlated significantly with each other and with concurrent suicidal ideation. PMS predicted suicide-specific rumination and attentional fixation. All CAS-components predicted NMS. Suicide-specific rumination, attentional fixation, and positive and negative metacognitions differentiated between lifetime suicide attempters and non-attempters. Conclusion Results are in line with the metacognitive model of suicidality and warrant further studies regarding the model assumptions.

High CSF neurogranin level is related to lifetime reports of passive suicidal ideation in a population-based sample of older adults

ObjectiveTo investigate the association of cerebrospinal fluid (CSF) levels of markers of synaptic dysfunction and neuronal damage, neurogranin (Ng) and neurofilament light chain (NfL), with suicidal ideation in older adults. MethodThe sample was obtained from the Gothenburg H70 Birth Cohort Studies and included 316 dementia free individuals (151 women, 165 men, mean age 70.6) who underwent extensive psychiatric examinations and lumbar puncture (LP). Suicidal ideation was assessed using the Paykel questions. ResultsPast year suicidal ideation (any severity level) was reported by 9 (2.8%) participants while 58 (18.4%) reported experiencing such ideation during their lifetime. High CSF Ng level was associated with lifetime reports of life weariness (OR 2.03, 95% CI 1.01-4.11, P = 0.048), death wishes (OR 2.26, 95% CI 1.02-4.98, P = 0.044) and thoughts of taking one’s own life (OR 3.17, 95% CI 1.31-7.65, P = 0.010) in adjusted logistic regression models including self-reported lifetime depression as a covariate. The association between high CSF Ng level and lifetime suicidal ideation (all severity levels) remained in models adjusted for CSF levels of amyloid beta 42 (Aβ42), T-Tau and P-Tau. No relationship was seen between high CSF NfL and suicidal ideation. ConclusionThe association between high CSF Ng level and history of suicidal ideation suggests that synaptic dysfunction may be involved in the diathesis of passive suicidal ideation. CSF markers of neurodegeneration did not modify these findings.

Non-Fatal Suicidal Self-Directed Violence among U.S. Veterans (2022): The Assessing Social and Community Environments with National Data (ASCEND) for Veteran Suicide Prevention Study.

From 2001-2021, the age- and sex-adjusted Veteran suicide rate increased 76.3%. Surveillance of suicidal ideation (SI) and non-fatal suicidal self-directed violence (NF-SSDV) is a critical component of public health-oriented suicide prevention efforts. To facilitate national NF-SSDV surveillance, a biennial, population-based survey was initiated: Assessing Social and Community Environments with National Data (ASCEND) for Veteran Suicide Prevention. 17,396 Veterans participated in the first large-scale ASCEND survey (2022). This manuscript reports on SI and NF-SSDV prevalence among Veterans residing in the continental U.S., Hawaii, and Puerto Rico. Lifetime SI was reported by 31.98% (95%CI=30.97-32.99), post-military SI by 25.88% (95%CI=24.91-26.85) and past-year SI by 12.69% (95%CI=11.90-13.47). The most commonly considered SI method among those with past-year SI was gunshot. Additionally, 34.42% (95%CI=33.07-35.78) of Veterans with lifetime SI reported lifetime preparatory behaviors. Moreover, 9.13% (95%CI=8.43-9.82) of Veterans reported lifetime interrupted attempts. Lifetime suicide attempts (SA) were reported by 6.99% (95%CI=6.41-7.56) of Veterans, with 4.88% (95%CI=4.39-5.36) reporting post-military SA. The most common method in prior attempts was medication overdose. ASCEND provides a novel opportunity to elucidate the prevalence of SI and different types of NF-SSDV in the Veteran population. Recurring administration will elucidate changes in SI and NF-SSDV prevalence in the Veteran population over time.

Prevalence and Clinical Correlates of Suicidal Ideation and Attempts in Individuals at Clinical High Risk for Psychosis.

Individuals with psychosis symptoms are at high risk for suicidal ideation and attempts. The prevalence and correlates of suicidal ideation and attempts in clinical high risk for psychosis (CHR-P) have yet to be clarified. This study reports on the prevalence and clinical correlates of suicidal ideation and attempts in a clinical CHR-P sample. Participants (n = 135) included CHR-P clients at a CHR-P community specialty clinic, who participated in a clinical assessment between 2017 and 2022. Assessments measured attenuated psychosis symptoms, suicidal ideation and attempts, clinical covariates, and functioning. Frequency analyses assessed the prevalence of lifetime suicidal ideation and attempts and t-test and Chi-square identified clinical correlates. Logistic regression assessed the relationship between significant clinical correlates and lifetime suicide attempts. Sixty-five percent of participants at CHR-P endorsed lifetime suicidal ideation, while 22.2% reported at least one lifetime attempt. Correlates for lifetime suicidal ideation included self-reported gender expansive identity, hopelessness, depression, trauma, obsessive compulsive symptoms, insight: reflectiveness, trauma diagnoses, mood disorder diagnoses, and perceptual abnormalities/hallucinations. Significant correlates for lifetime suicide attempts included self-reported hopelessness, depression, trauma diagnosis and mood disorder diagnosis. CHR-P clients are at a higher risk for suicidal ideation and attempts compared to the general population. Correlates of suicidal ideation and attempts may be diagnostically heterogeneous and therefore interventions should be tailored to specific clinical needs. Clients with trauma-disorder diagnoses may be at highest risk for suicidal ideation and attempts. Continued intervention and longitudinal research is needed to clarify causal risk factors and establish evidence-based treatments for suicidal ideation and attempts in CHR-P.

Preliminary findings from caregiver reports on suicidality and contextual risk factors in Canadian minoritized youth with fetal alcohol spectrum disorder

Objectives Individuals with prenatal alcohol exposure (PAE) and fetal alcohol spectrum disorder (FASD) experience a range of biopsychosocial vulnerabilities that can increase their risk for negative outcomes, including suicidality. Experiences of suicidality in youth can have tremendous impacts on caregivers and families. Although there is mounting evidence for the elevated rates of suicidality among individuals with FASD, very little is known about the full spectrum of suicidality (i.e. frequency, severity, and duration of current and lifetime suicidal ideation and/or behaviours) in these individuals. Methods To better comprehensively characterize suicidality and explore contextual factors among youth with PAE/FASD, we conducted an online survey using the Columbia-Suicide Severity Rating Scale (CSSR-S) with 22 caregivers to leverage their wisdom and experiences related to suicidality. Results Caregivers highlighted the notable acuteness, severity, and persistence of suicidality among their youth with PAE/FASD. In addition, open-ended qualitative responses revealed important information regarding the context surrounding suicidality for youth with PAE/FASD, including a reactive response to frustration or conflict, shame and not fitting in, and a general sense of hopelessness. Conclusions Caregiver responses in this study highlight the critical need for comprehensive PAE/FASD-informed suicide prevention and intervention strategies to promote the mental health and wellbeing of individuals with PAE/FASD and their families.

Suicide risk among residents and PhD students: A systematic review of the literature.

Residents and PhD students (any discipline) are susceptible to various mental health issues, including suicidal thoughts and behaviors. This systematic review aimed to (1) estimate the prevalence of suicide-related outcomes among residents/PhD students and (2) assess the associated variables. PubMed, PsycINFO, and Scopus databases were searched for articles documenting quantitative information about suicide-related outcomes among residents and PhD students from inception until April 30, 2023. Sixty studies were included. Estimates of the current prevalence of the following suicide-related outcomes were: death wishes (DW), 9.1%; suicidal ideation (SI), 8.6%; suicidal planning (SP), 3.2%; non-suicidal self-injury (NSSI), 1.9%; suicide attempt(s) (SA), .8%. Additionally, estimates of the lifetime prevalence were: lifetime SI (L-SI), 25.9%; lifetime SP (L-SP), 10.0%; lifetime SA (L-SA), 3.1%. Depression, burnout, hopelessness, loneliness, low quality of the relationship with the supervisor and experiencing workplace mistreatment frequently co-occurred with the assessed outcomes. Many outcomes (DW, SI, SP, L-SI, L-SP, L-SA) had a higher prevalence compared to the general population, while some (SI, NSSI, SA) were lower compared to undergraduates. Interventions for individuals at risk in this population are vital together with the modification of the work environment and the promotion of a supportive academic and professional culture to reduce suicide risk.

Assessing suicidality in adult ADHD patients: prevalence and related factors

BackgroundThe association between Attention-deficit hyperactivity disorder (ADHD) and suicidality has been subject of growing interest for research in the latest years. Suicidality was generally assessed categorically and without the use of validated instruments, leading to heterogeneous or even conflicting evidence. The prevalence of both suicidal ideation and attempts varies considerably, and the associated risk factors remain unclear. Our study investigated suicidality in ADHD using a dimensional approach and a validated and internationally recognized instrument. Our primary aim was to evaluate the prevalence of suicidal ideation (SI), severe suicidal ideation (SSI), suicidal behavior (SB) and non suicidal self-injury behavior (NSSIB) in a sample of adult patients with ADHD. The second objective was to identify sociodemographic and clinical features associated with increased risk of suicidality in these patients.MethodsThe sample included 74 adult patients with clinical diagnosis of ADHD. Suicidality was assessed by administering the Columbia-Suicide Severity Rating Scale. Logistic regressions were used to examine predictors of SI, SSI, SB and NSSIB.ResultsThe lifetime prevalence of SI and SSI were 59.5% and 16.2%, respectively. The 9.5% of patients showed lifetime SB, while NSSIB was found in 10.8% of the subjects. Lifetime SI was associated with severity of inattentive symptoms during adulthood, low self-esteem and impairment in social functioning. Lifetime SSI appeared related to severity of inattentive symptoms during childhood, attentional impulsiveness and number of hospitalizations, while physical activity appeared to be protective. The prevalence of lifetime SB and NSSIB did not appear significantly related to any socio-demographic or clinical feature.ConclusionsAdults with ADHD should be considered at risk of suicide and it is important to determine which patients are at higher risk, in order to guide preventive interventions. The association between ADHD and suicidal ideation did not appear to be influenced by psychiatric comorbidities, but rather by inattention itself, which represents the core symptom of ADHD.

Heightened suicidal risk in ADHD and subthreshold ADHD: Understanding the role of psychiatric comorbidities

ObjectivesRecently, adult ADHD diagnoses have increased, complicating treatment when comorbid with other disorders. Subthreshold ADHD(sADHD) also poses challenges, especially with comorbidities and suicidality. This study explores psychiatric comorbidities' role in ADHD and sADHD suicidality. MethodsWe analyzed microdata from the National Mental Health Survey of Korea 2021 to examine the association of ADHD on comorbidities and suicide-related behaviors. ResultsOf the 5511 participants, 194(3.52 %) were diagnosed with ADHD, and 775(14.1 %) had sADHD. In 12-month prevalence, suicidal ideation and plans were more prevalent in both ADHD and sADHD patients than in controls, with higher odds ratios(ADHD vs. control OR 12.87; suicidal ideation, 54.06; suicidal plan, sADHD vs control OR 8.26; suicidal ideation, 17.63; suicidal plans). Lifetime suicidal ideation and plans were notably associated with alcohol use disorder(OR 6.15 in ideation, 3.83; plan) and nicotine use disorder in participants with ADHD(OR 5.36 in ideation, 5.31; plan), whereas sADHD associations were found with alcohol use disorder(OR 1.80 in ideation) and depressive disorder(OR 1.90 in ideation) compared to the controls. Additionally, differences in suicidal behavior between sADHD and ADHD were identified for alcohol use disorder(OR 3.42 in ideation, 4.15; plan) and nicotine use disorder(OR 4.02 in ideation, 4.98 in plan). ConclusionThese results indicated a heightened risk of psychiatric comorbidities and suicidal ideation or plans in the ADHD and sADHD groups. These results suggest the need for a more diverse focus on comprehensive mental health assessments and proactive support for patients with ADHD, regardless of symptom severity.

Perinatal Factors and Their Association with Early-Adulthood Suicidal Behavior in a Brazilian Birth Cohort

Background The objectives of this study were to investigate the relationship between perinatal risk factors and suicidal ideation and attempts in young adults in Pelotas, Brazil. Methods The data were collected from the 1993 Pelotas Birth Cohort study. Every pregnant woman who gave birth in one of the hospitals in Pelotas Brazil in 1993 was invited to participate in the study. The current study uses perinatal data collected in 1993, and follow-ups at ages 18 and 22. The primary outcome was lifetime suicide attempts with past month suicide ideation a secondary outcome. The association between perinatal predictors and suicidal ideation or lifetime suicide attempts was investigated using hierarchical logistic regression. Findings There was an analytic sample size of 3493. The perinatal factors association with lifetime suicide attempts were sex (OR = 2.25 CI: 1.76–2.89), paternal education at birth (OR = 0.60, 95%CI: 0.36–0.99), maternal education (9–11 years OR = 2.81, 95%CI: 1.41–5.59, & 0–8 years OR = 2.21, 95%CI: 1.07–4.58), support from friends or neighbors at birth (OR = 0.36 95%CI: 0.17–0.77), and maternal smoking during pregnancy (OR = 1.41, 95%CI: 1.10–1.79). Patterns of associations were broadly similar with suicidal ideation. Interactions between sex and the perinatal factors paternal education, maternal education, smoking and support from friends were assessed and found to be not significant. Conclusion Several factors during the perinatal period are associated with risk of lifetime suicide attempts and ideation in young adults in Brazil. Early-life factors associated with suicide-related concerns in early adulthood were similar to those observed in studies from high-income settings.

Mental health of Irish adolescents following the COVID-19 pandemic: results from a population-based cross-sectional survey.

This study provides data on the prevalence of mental health problems among adolescents in Ireland in 2021, toward the end of the COVID-19 pandemic. The importance of having recent, large-scale, mental health data for adolescents has been heightened by COVID-19, the increased demand for child and adolescent mental health services, and the rapidly changing adolescent environment. As part of the Planet Youth study, a cross-sectional survey of adolescents (N = 4,404), mostly aged 15-16, was conducted between September and December 2021. Participants were recruited from 40 schools and non-traditional educational centres across 3 regions in Ireland, one predominantly urban (North Dublin) and two predominantly rural (Cavan, Monaghan). A range of mental health outcomes were self-reported: a single-item question on mental health; the Strengths & Difficulties Questionnaire (SDQ); depressive and anxiety symptoms from the Symptom Check List 90; the Adolescent Psychotic-like Symptom Screener; and lifetime self-harm, suicidal ideation, and attempt. Over a quarter of adolescents described their mental health as 'bad' or 'very bad' (29%), and had SDQ total problem scores over 20 (26%). Over a third (39%) reported self-harming, 42% reported suicidal ideation, and 11% reported attempting suicide, in their lifetime. Gender-diverse youth (non-binary, trans, and undisclosed) had higher rates of poor mental health outcomes compared to cis-gendered youth (male/female), and females had higher rates of most mental health outcomes compared to males. Many of these estimates suggest a deterioration from previous epidemiological studies. While our findings do not definitively prove youth mental health has worsened over time, these findings are highly concerning. We propose a close monitoring of mental health in future surveys of this population and encourage initiatives to improve the capacity and quality of youth mental health services.

Understanding experiences of non-physical maltreatment in childhood in Canada: What is the relationship with suicidal ideation and mental health disorders?

Physical and sexual childhood abuse are associated with suicidal ideation and mental health disorders. However, less is known about non-physical types of maltreatment. This study examined associations between non-physical types of child maltreatment (e.g., emotional abuse, interpersonal aggression, exposure to physical intimate partner violence, emotional and physical neglect) and suicidal ideation, and mental health disorders. Data from the 2018 Survey of Safety in Public and Private Spaces were used to estimate the proportion of individuals 15 years and older in Canada who experienced non-physical maltreatment during childhood. Multivariable regression analyses were used to examine associations between five types of non-physical child maltreatment and suicidal ideation, and mental health disorders. Overall, interpersonal aggression was the most common (45.7%), followed by emotional abuse (40.4%) and emotional neglect (20.0%). Individuals who experienced any type of non-physical maltreatment in childhood had a higher probability of lifetime suicidal ideation than those who never experienced the maltreatment examined. Mood disorder diagnoses were more likely among those who experienced emotional abuse, interpersonal aggression, and emotional neglect than among those who never experienced these types of maltreatment. Compared with those who never experienced the maltreatment examined, individuals who experienced emotional abuse, interpersonal aggression, emotional neglect, or physical neglect were more likely to be diagnosed with an anxiety disorder. Diagnoses of post-traumatic stress disorder were more likely among those who experienced emotional and physical neglect than among those who never experienced these types of maltreatment. Non-physical child maltreatment is associated with suicidal ideation and mental health disorders. The findings highlight the importance of including non-physical types of child maltreatment on population-based surveys to differentiate associations with mental health outcomes to better align interventions and policies.

A Canadian national study of provincial and territorial correctional workers' suicidal ideation, plans, and attempts.

Correctional workers (CWs) endure several operational stressors (e.g., exposures to potentially psychologically traumatic events) and organisational stressors (e.g., shift work, staff shortages), which are associated with positive screens for mental disorders and self-reports of suicidal behaviours and thus urgently warrant further inquiry. The Canadian Provincial and Territorial Correctional Worker Mental Health and Well-Being Study (CWMH) used an online survey to collect data from Canadian correctional service organisations across all 13 provinces and territories. This national Canadian study investigates suicidal behaviours among CWs across diverse occupational roles and provincial and territorial jurisdictions (n=3740, 50.1% female). The results estimated prevalence proportions for self-reported past-year and lifetime suicidal thoughts, planning, and attempts across the 13 Canadian provincial and territorial correctional systems, with the exceptions of past-year suicidal planning in Alberta, Newfoundland and Labrador, New Brunswick, and Yukon where jurisdictional considerations and requests precluded the inclusion of select questions. Substantial proportions of participants reported past-year or lifetime suicidal ideation (i.e., 9.1%, 29.2%, respectively), planning (i.e., 4.1%, 14.7%, respectively), or attempts (i.e., 0.8%, 7.2%, respectively). Sociodemographic variables (i.e., sex, age, marital status, total years of service, occupational category) were associated with past-year and lifetime suicidal behaviours. Findings provide opportunities for future research and can inform tailored efforts by clinicians, service providers, and organisational leaders to support proactive interventions and treatments, including supporting the partners and families of CWs, fostering social support networks, and improving access to timely mental health treatment.

Relations between worry, thought control, suicidal ideation and attempt history

ABSTRACT Background Thought processes such as worries are often described as difficult to control and predict suicidal thoughts and behaviors (STBs). Due to their uncontrollable nature, worries may lead to STBs as people attempt to escape their own internal thought processes. Objective Examine the indirect role of perceived uncontrollability of one’s thoughts in the relationship between worry and STBs. Design and Method We used stepwise mediation models to examine the proposed relationship in a sample of 145 undergraduates with lifetime suicidal ideation. STBs were categorized into (1) severity of lifetime suicidal ideation, (2) likelihood and (3) severity of recent suicidal ideation, and (4) lifetime suicide attempt. The likelihood and severity of recent ideation were separated due to the skewed nature of suicidal thoughts, with many people reporting zero ideation. Results Worry was related to the severity of lifetime ideation, the likelihood of reporting recent ideation, and the severity of recent ideation through lower levels of perceived ability to control one’s thoughts. Worry was not related to a lifetime suicide attempt. Conclusion The perception that one’s thoughts are uncontrollable may be a core feature of worry for the development and worsening of suicidal thinking. Interventions targeting internal perceptions of uncontrollability may be beneficial for suicidal ideation management.

Predicting the trajectory of non-suicidal self-injury among adolescents.

Non-suicidal self-injury (NSSI) is common among adolescents receiving inpatient psychiatric treatment and the months post-discharge is a high-risk period for self-injurious behavior. Thus, identifying predictors that shape the course of post-discharge NSSI may provide insights into ways to improve clinical outcomes. Accordingly, we used machine learning to identify the strongest predictors of NSSI trajectories drawn from a comprehensive clinical assessment. The study included adolescents (N = 612; females n = 435; 71.1%) aged 13-19-years-old (M = 15.6, SD = 1.4) undergoing inpatient treatment. Youth were administered clinical interviews and symptom questionnaires at intake (baseline) and before termination. NSSI frequency was assessed at 1-, 3-, and 6-month follow-ups. Latent class growth analyses were used to group adolescents based on their pattern of NSSI across follow-ups. Three classes were identified: Low Stable (n = 83), Moderate Fluctuating (n = 260), and High Persistent (n = 269). Important predictors of the High Persistent class in our regularized regression models (LASSO) included baseline psychiatric symptoms and comorbidity, past-week suicidal ideation (SI) severity, lifetime average and worst-point SI intensity, and NSSI in the past 30 days (bs = 0.75-2.33). Only worst-point lifetime suicide ideation intensity was identified as a predictor of the Low Stable class (b = -8.82); no predictors of the Moderate Fluctuating class emerged. This study found a set of intake clinical variables that indicate which adolescents may experience persistent NSSI post-discharge. Accordingly, this may help identify youth that may benefit from additional monitoring and support post-hospitalization.

Gender Differences in Gambling Disorder: Results from an Italian Multicentric Study.

Although gender-specific evidence on Gambling Disorder (GD) is still limited, some studies reported specific differences, mainly in psychopathological profiles, gambling behavior patterns, and pathogenesis. In order to further examine the role of gender in GD, we conducted a multicenter investigation in a sample of Italian outpatients. One hundred-four outpatients with a diagnosis of GD based on DSM-5 criteria were consecutively recruited at two clinics based in Milan. Socio-demographic and clinical variables were collected for the whole sample and analyzed for the effect of gender. The severity of illness was assessed using the Canadian Problem Gambling Index and the Gambling Attitudes and Beliefs (GABS). Among females, a significantly higher mean age (52.23 ± 10.95 vs. 40.96 ± 15.76; p=0.005) and older age at illness onset emerged (43.5 ± 11.92 vs. 29.22 ± 14.26; p<0.001). Females showed a significantly higher rate of psychiatric comorbidities, lifetime suicide ideation, stressful events at GD onset, and positive family history for GD compared to males. A predictive effect of male gender was found for the GABS questionnaires by performing a linear regression model, with males showing a higher risk to reach higher scores compared to females (B= 11.833; t=2.177; p=0.034). Our study seems to confirm the hypotheses that gender in GD may influence psychopathological profiles, course, and comorbidity. GD in female gender is frequently a comorbid condition with other specific clinical characteristics compared to males. Identifying specific clinical factors by gender may prompt more focus on the public health of women in relation to gambling, while still recognizing that males are at-risk of earlier gambling problems. These findings should be considered in therapeutic perspectives.

Disaggregating Data Regarding Suicidal Ideation and Suicide Attempts among Post-9/11 Asian American and Pacific Islander Veterans

The suicide rate among Asian American and Pacific Islander veterans has increased; however, data aggregation for these groups, combined with underinclusion in research, limits understanding regarding risk. We conducted a secondary analysis of Comparative Health Assessment Interview Research Study 2018 data to compare suicidal ideation (SI) and suicide attempt (SA) prevalence among 668 post-9/11 veterans who identified as Asian American, Pacific Islander, or both and described SI and SA prevalence among specific subgroups. Veterans who identified as both Asian American and Pacific Islander were more likely to report experiencing SI (lifetime and during their military service), compared to those who identified solely as Asian American or Pacific Islander (military SI only). Statistically significant differences were not detected for SI preceding or following military service or for lifetime SA. Weighted estimates for lifetime SI and SA were 24.2% and 6.5%, respectively, and prevalence varied widely among specific Asian American and Pacific Islander groups. However, small cell sizes and wide confidence intervals were limitations. Increased clinical attention to screen for and mitigate suicide risk among veterans who identify as both Asian American and Pacific Islander may be warranted. To ensure that suicide prevention strategies optimally address their needs and experiences, research is needed to elucidate suicide drivers in this population. Considering the heterogeneity in SI and SA prevalence among different Asian American and Pacific Islander groups, continued research with larger subsamples that disaggregates analyses by race and ethnicity is essential to deliver prevention and health promotion strategies targeted to the highest-risk groups.

Psychological resilience and suicidality in the general population: A cross-sectional study based on data from the National Mental Health Survey of Korea 2021

BackgroundThe relationship between suicidality and resilience is underexplored among the general population. This study aimed to explore the relationship between lifetime, one-year, and one-month prevalence of suicidality (ideation, plan, attempt) and resilience in the general population. MethodsData on suicidality, resilience, prevalence of major mental disorders, and other key psychological factors were collected from the National Mental Health Survey of Korea 2021. Interviewees comprised 5511 South Koreans aged 18–79 years. The contribution of resilience to suicidality was evaluated using Rao–Scot logistic regression, adjusting for possible confounders such as mental disorder prevalence and demographic and psychological characteristics. ResultsSignificantly lower resilience levels were noted among participants who reported lifetime, one-year, and one-month suicidal ideation, plan, or attempts. High resilience levels predicted no suicidal ideation, plans, and attempts in the lifetime, and no suicidal ideation and plans in the one-year and one-month time frames. LimitationsFirst, this study's cross-sectional design has limitations for ascertaining a causal relationship between resilience and suicidality. Second, because the number of participants who had attempted suicide in the past year and reported suicidal thoughts/attempts in the past month was small, there were limitations in the analysis of suicidality in these time frames. Third, it was difficult to rule out the mediating effects of personality and temperament on the relationship between resilience and suicidality. ConclusionsHigh resilience levels predicted lower lifetime and current suicidal ideation and suicidal planning in the general population. This study shows that psychological resilience is an important factor in evaluating an individual's current suicidality.

A Secondary Analysis of the Complex Interplay between Psychopathology, Cognitive Functions, Brain Derived Neurotrophic Factor Levels, and Suicide in Psychotic Disorders: Data from a 2-Year Longitudinal Study.

Identifying phenotypes at high risk of suicidal behaviour is a relevant objective of clinical and translational research and can facilitate the identification of possible candidate biomarkers. We probed the potential association and eventual stability of neuropsychological profiles and serum BDNF concentrations with lifetime suicide ideation and attempts (LSI and LSA, respectively) in individuals with schizophrenia (SCZ) and schizoaffective disorder (SCA) in a 2-year follow-up study. A secondary analysis was conducted on a convenience sample of previously recruited subjects from a single outpatient clinic. Retrospectively assessed LSI and LSA were recorded by analysing the available longitudinal clinical health records. LSI + LSA subjects consistently exhibited lower PANSS-defined negative symptoms and better performance in the BACS-letter fluency subtask. There was no significant association between BDNF levels and either LSI or LSA. We found a relatively stable pattern of lower negative symptoms over two years among patients with LSI and LSA. No significant difference in serum BDNF concentrations was detected. The translational viability of using neuropsychological profiles as a possible avenue for the identification of populations at risk for suicide behaviours rather than the categorical diagnosis represents a promising option but requires further confirmation.

Psychache, Hopelessness, and Suicidal Ideation and Behaviors: A Cross-Sectional Study from China.

This study explored the relationship between variables emphasized in the theory's first step of the three-step theory (3ST)-psychache, hopelessness, and their interaction-to suicide-related variables (i.e., lifetime suicidal ideation and attempt, past-year suicidal ideation, communication of suicidal thoughts, and self-reported future suicide attempt likelihood). Chinese undergraduate students (N = 11,399; mean age = 20.69 ± 1.35) from seven provinces participated in this cross-sectional survey. They answered the Suicidal Behaviors Questionnaire-Revised, Psychache Scale, and Beck Hopelessness Scale. Bivariate and multivariate analyses were used to examine the association between psychache, hopelessness, and hopelessness × psychache interaction on the outcome variables. Bivariate analyses showed that psychache and hopelessness were correlated with suicidal ideation and behaviors. In multiple regression models, the interaction between psychache and hopelessness was significantly associated with past-year suicidal ideation and self-report chances of a future suicide attempt, p < 0.001, though effect sizes for the interaction term were small. The results are broadly consistent with the 3ST's proposition of how the combination of pain and hopelessness is related to various suicide-related variables. The low prevalence of suicide-related communication should inform future suicide prevention measures by encouraging help-seeking. Psychache as a correlate of the self-reported likelihood of a future attempt could be further investigated.

Attachment Style, Social Support Network, and Lifetime Suicide Ideation and Suicide Attempts Among New Soldiers in the U.S. Army

Objective Attachment style and social support networks (SSN) are associated with suicide ideation (SI) and suicide attempt (SA). How these two factors interact is important to understanding the mechanisms of risk for suicidal behaviors and identifying interventions. Method Using the Army Study to Assess Risk and Resilience in Servicemembers New Soldier Study (N = 38,507 soldiers), we examined how three attachment styles (preoccupied, fearful, and secure) and SSN (smaller vs larger) were associated with lifetime SI, SA, and SA among soldiers with SI. The interaction of each attachment style by SSN was examined. Results All three attachment styles were associated with SI and SA in the total sample (for SA: preoccupied OR = 2.82, fearful OR = 2.84, and secure OR = 0.76). Preoccupied and fearful attachment were associated with SA among suicide ideators. Smaller SSN was associated with a higher risk for all three outcomes (range of ORs = 1.23–1.52). The association of SSN with SI and with SA among suicide ideators was significantly modified by the presence or absence of preoccupied attachment style. Among soldiers without preoccupied attachment, larger SSN was associated with lower risk of SI. Among suicide ideators with preoccupied attachment, a larger SSN was associated with lower risk of SA. Conclusion This study highlights the need for increased understanding of the role of attachment style and social networks in suicide risk, in particular preoccupied attachment among soldiers with SI. A critical next step is to explore these relationships prospectively to guide intervention development.