Risk Of Lifetime Suicide Attempts Research Articles

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.

Childhood emotional dysregulation paths for suicide-related behaviour engagement in adolescence.

This study aimed at identifying the heterogeneous trajectories of emotional dysregulation across childhood and to study the relationship between specific trajectories and adolescent suicide-related behaviour (SRB). Data from the Millennium Cohort Study (N = 13,853 children; 49.07% female, M = 3.13years at baseline, SD = 0.2) were used to identify the emotional dysregulation trajectories from 3 to 8years old, using growth mixture modelling. Moreover, 1992 participants (52.86% female) from the initial sample were used to study the relationship between childhood emotional dysregulation trajectory and engagement in both self-harm and suicide attempt at age 17, using logistic regression. Some other time-invariant and proximal (adolescent) risk factors were incorporated into this analysis. Six emotional dysregulation trajectories were identified. Self-harm at age 17 was significantly associated with the history of self-harm and other proximal factors, but not with emotional dysregulation trajectory membership. Childhood trajectories featured by earlier emotional dysregulation were associated with higher risk of lifetime suicide attempt, as well as other proximal factors (concurrent self-harm). This study found differential risk profiles involved in both SRB forms. A relationship between early emotional dysregulation and suicide attempt engagement in adolescence was identified. Early interventions should be developed to deal with SRB risk factors from childhood.

Genetic propensity for risky behavior and depression and risk of lifetime suicide attempt among urban African Americans in adolescence and young adulthood.

Suicide attempts (SA) among African Americans have increased at a greater rate than any other racial/ethnic group. Research in European ancestry populations has indicated that SA are genetically influenced; however, less is known about the genetic contributors that underpin SA among African Americans. We examined whether genetic propensity for depression and risky behaviors (assessed via polygenic risk scores; PRS) independently and jointly are associated with SA among urban, African Americans and whether sex differences exist in these relations. Participants (N=1,157, 45.0% male) were originally recruited as part of two first grade universal school-based prevention trials. Participants reported in adolescence and young adulthood on whether they ever attempted suicide in their life. Depression and risky behaviors PRS were created based on large-scale genome-wide association studies conducted by Howard et al. (2019) and Karlson Línner et al. (2019), respectively. There was a significant interaction between the risky behavior PRS and depression PRS such that the combination of high risky behavior polygenic risk and low/moderate polygenic risk for depression was associated with greater risk for lifetime SA among the whole sample and African American males specifically. In addition, the risky behavior PRS was significantly positively associated with lifetime SA among African American males. These findings provide preliminary evidence regarding the importance of examining risky behavior and depression polygenic risk in relation to SA among African Americans, though replication of our findings in other African American samples is needed.

Quality of life of patients with nonsuicidal self-injury: The role of suicidal ideation

IntroductionLower quality of life (QoL) scores are associated with suicidal behavior, both in the general population and in psychiatric patients. Nonsuicidal self-injury (NSSI) behavior is a public health concern because of its increasing prevalence and high risk of lifetime suicide attempt. Despite its significance QoL in patients with NSSI is underinvestigated. There is a gap in knowledge on the influence of suicidal ideation (SI) on certain domains and facets of QoL in patients with NSSI.ObjectivesThe study aimed to assess the impact of SI on QoL of patients with NSSI.MethodsWe conducted a case-control study (1:3): 13 consecutive patients (11 female) with non-psychotic mental disorders and NSSI without lifetime SI were compared to 39 age and gender matched patients with NSSI and SI. All patients were evaluated by a psychiatrist, underwent Self-Injurious Thoughts and Behaviors Interview (Nock MK et al., 2007) and filled out the World Health Organization Quality of Life Assessment 100 (WHOQOL-100). Mann-Whitney and Fishers exact test were used as statistical methods.ResultsThe overall QoL (p=0.001) and the perception of life (p=0.005) were significantly higher in patients without SI. Patients with SI had a lower scores in psychological (p=0.002), social (p=0.036) and spiritual (p=0.005) domains as well as lower rates in energy (p<0.02); positive emotions (p<0.001); thinking, learning, memory and concentration (p=0.007); self-esteem (p=0.013); negative emotions (p=0.035); activities of daily living and participation (p=0.014) and opportunities for recreation/leisure facets (p=0.007).ConclusionsSI in patients with NSSI was found to be associated with worse QoL

Suicide attempts among people with eating disorders and adverse childhood experiences: Results from a nationally representative sample of adults.

People with eating disorders (EDs) have elevated rates of suicide attempts. A need exists to identify factors that help predict which people with EDs might be at greater risk for suicidal behavior. Adverse childhood experiences (ACEs) are associated with both EDs and with suicide attempts. Thus, the current study examined whether having histories of ACEs and EDs augments lifetime risk for suicide attempts. This study included 36,146 adult participants in the National Epidemiologic Survey on Alcohol and Related Conditions-III who completed structured diagnostic interviews and answered questions regarding ACEs and suicide attempts. Weighted means, frequencies, and cross-tabulations were computed for prevalence of ACEs and suicide attempts by ED diagnosis. Multiple logistic regression was used to compare risk of lifetime suicide attempts by ED diagnosis and ACE history. Prevalence of ACEs among people with EDs was 54.1-67.8%. ACE history and ED diagnosis were associated with elevated odds of experiencing a lifetime suicide attempt (AORs = 4.64-6.45 and 3.20-4.06, respectively). There was no ACE history-by-ED interaction on risk of suicide attempt, regardless of forms of EDs. ACEs are common among people with EDs and associated significantly with suicide attempts, but ACEs and EDs do not appear to interact to augment risk for suicide attempts. Considering ACE exposure in theoretical models of suicidal behavior in people with and without EDs and in suicide risk assessment and management with people with EDs may prove useful.

Relationship Between Adverse Childhood Experiences and the Risk of Lifetime Suicide Attempts

Objectives This study aims to examine the effect of adverse childhood experiences (hereafter ACE) on the risk of lifetime suicide attempts. Methods Cross-sectional data of a sample of 1,396 individuals aged 18-64 years were obtained from the Korean General Social Survey (KGSS) in 2012. Frequency, chi-square analysis, and logistic regression were conducted, utilizing both the SPSS 25.0 and Stata 16. Additionally, population attributable fractions (hereafter PAF) were calculated to determine the proportion of lifetime suicide attempts attributable to ACE. Results First, parental divorce or separation, witnessing intimate partner violence, and sexual victimization, each increased the risk of lifetime suicide attempts by three times. Compared with those without ACE, the cumulative risk odds of lifetime suicide attempts increased more than five times among those with four or more ACE. Additionally, the estimated PAF for lifetime suicide attempts to cumulative ACE scores ranged from 8% to 14% among the participants. A substantial proportion of suicide attempts was attributable to the increasing number of ACE. Conclusion The risk of experiencing lifetime suicide attempts increased with increasing ACE scores. ACE prevention actions should carefully consider how ACE may exacerbate the risk of lifetime suicide attempts. Keywords: adverse childhood experiences, ACE, suicide attempts, PAF, KGSS

Effects of Multiple Forms of Information Bias on Estimated Prevalence of Suicide Attempts According to Sexual Orientation: An Application of a Bayesian Misclassification Correction Method to Data From a Systematic Review.

Multiple epidemiologic studies demonstrate a disparity in suicide risk between sexual minority (lesbian, gay, bisexual) and heterosexual populations; however, both "exposure" (sexual minority status) and outcome (suicide attempts) may be affected by information bias related to errors in self-reporting. We therefore applied a Bayesian misclassification correction method to account for possible information biases. A systematic literature search identified studies of lifetime suicide attempts in sexual minority and heterosexual adults, and frequentist meta-analysis was used to generate unadjusted estimates of relative risk. A Bayesian model accounting for prior information about sensitivity and specificity of exposure and outcome measures was used to adjust for misclassification biases. In unadjusted frequentist analysis, the relative risk of lifetime suicide attempt comparing sexual minority with heterosexual groups was 3.38 (95% confidence interval: 2.65, 4.32). In Bayesian reanalysis, the estimated prevalence was slightly reduced in heterosexual adults and increased in sexual minority adults, yielding a relative risk of 4.67 (95% credible interval: 3.94, 5.73). The disparity in lifetime suicide attempts between sexual minority and heterosexual adults is greater than previously estimated, when accounting for multiple forms of information bias. Additional research on the impact of information bias in studies of sexual minority health should be pursued.

Military sexual trauma and suicidal behavior among National Guard personnel

BackgroundPreliminary evidence suggests military sexual trauma (MST) may be associated with increased risk for suicidal behaviors among active duty military personnel and veterans. Among National Guard personnel, a high-risk subgroup, MST and suicide risk have not received much empirical attention. PurposeTo examine the association of MST with suicide ideation and suicide attempts among National Guard personnel. ProceduresN = 997 National Guard personnel from Idaho and Utah participated in an anonymous online survey. Weighted analyses were conducted to minimize sampling bias. Main findings9% of participants had a history of MST (6% of men, 28% of women). Among participants reporting MST, 68% reported a service member perpetrator and 44% reported a civilian perpetrator (12% reported both). A history of MST was associated with significantly increased risk for lifetime suicide attempt. MST remained a significant predictor of lifetime suicide attempt even when restricting the sample to the subgroup with a history of suicidal thoughts (n = 257, 27% of full sample). When adjusting for premilitary sexual victimization, MST was no longer significantly associated with lifetime suicide attempts, but premilitary sexual victimization was. ConclusionsThe rate of MST among National Guard personnel is comparable to rates among active duty military personnel, although the perpetrators of MST are less likely to be service members. MST is a risk factor for suicide attempts, but premilitary sexual victimization is a relatively stronger risk factor.

Comorbid PTSD and Social Anxiety Disorder: Associations With Quality of Life and Suicide Attempts.

Posttraumatic stress disorder (PTSD) and social anxiety disorder (SAD) frequently co-occur. Preliminary data from treatment-seeking and veteran samples suggest that the impact of PTSD-SAD comorbidity may be additive, conferring distress and impairment beyond that of either disorder alone. The current study sought to clarify and extend existent research using wave 2 of the National Epidemiologic Survey of Alcohol and Related Conditions, an epidemiological sample of American adults. Individuals who met criteria for comorbid PTSD-SAD were compared to those with either disorder alone on measures of lifetime suicide attempts or quality of life as measured by the Medical Outcomes Study Questionnaire. Relative to those with either PTSD or SAD, individuals with comorbid PTSD-SAD demonstrated an elevated risk of lifetime suicide attempts and substantially lower levels of physical and mental quality of life. The psychosocial consequences of PTSD-SAD comorbidity are substantial. Patients may benefit from early interventions to remediate social distress and improve support networks before more intensive psychotherapeutic interventions.

Associations of suicidality with cognitive ability and cognitive insight in outpatients with Schizophrenia

BackgroundPrevious literature suggests that better cognitive ability and insight are associated with greater lifetime risk of suicide attempts in schizophrenia, counter to the direction of association in the general population. However, the conjoint association between distinct cognitive domains, insight, and suicidality has not been assessed. MethodIn a cross-sectional study, 162 adults with schizophrenia or schizoaffective disorder completed cognitive testing via the MATRICS battery, symptom and cognitive insight assessments, along with the Columbia Suicide Severity Rating Scale. We then contrasted participants based on history of suicidality by cognitive domains and insight measures and conducted multivariate analyses. ResultsAlthough a history of any passive ideation was not associated with cognitive ability or insight, verbal learning was positively associated with a greater history of suicidal attempt and prior ideation with a plan and intent. Higher cognitive insight, and the self-reflectiveness subscale insight, was also associated with history of passive or active suicidal ideation. Cognitive insight and cognitive ability were independent from each other, and there were no moderating influences of insight on the effect of cognitive ability on suicide related history. Exploratory analyses revealed that history of planned attempts were associated with greater verbal learning, whereas histories of aborted attempts were associated with poorer reasoning and problem-solving. ImplicationsAlthough cross-sectional and retrospective, this study provides support that greater cognitive ability, specifically verbal learning, along with self-reflectiveness, may confer elevated risk for more severe suicidal ideation and behavior in an independent fashion. Interestingly, poorer problem-solving was associated with aborted suicide attempts.

Suicidality and sexual orientation: Characteristics of symptom severity, disclosure, and timing across the life course.

This investigation explored suicide-related characteristics and help-seeking behavior by sexual orientation. Population-based data are from the California Quality of Life Surveys, which included 1,478 sexual minority (lesbian, gay, bisexual, and homosexually experienced individuals) and 3,465 heterosexual individuals. Bisexual women had a nearly six-fold increased risk of lifetime suicide attempts than heterosexual women (RR = 5.88, 95%CI: 3.89-8.90), and homosexually experienced men had almost 7 times higher risk of lifetime suicide attempts than heterosexual men (RR = 6.93, 95%CI: 3.65-13.15). Sexual minority men and women were more likely than heterosexual men and women to have disclosed suicide attempts to a medical professional (RR = 1.48 and RR = 1.44, respectively). Among persons who ever attempted suicide, sexual minority women had a younger age of index attempt than heterosexual women (15.9 vs. 19.6 years of age, respectively). Healthcare professionals should be aware of suicidal risk heterogeneity among sexual minority individuals, including vulnerable points of risk and evidenced-based treatments.

Suicidality Among Various Diagnostic Groups

Introduction The presence of mental illness has been found to be one of the major predictors of suicidality. Further, a lifetime history of suicide attempts increase the risk of death by suicide. Objectives Suicidality differs among diagnostic groups, with the strongest association being with mood disorders, but also with schizophrenia and anxiety disorders. Accordingly, we explored the differences in suicidality among various diagnostic groups. Aims To identify a diagnostic group with the highest risk of suicidality. Methods The study sample consisted of 122 patients categorized into three diagnostic groups: those with schizophrenia spectrum disorders (n=56), those with mood disorders (n=40) and those with anxiety disorders (n=26), mean age of 37.38 years. Assessment instruments included the Beck Scale for Suicide Ideation and the semistructured questionnaire for suicidal behaviour (lifetime history and method of suicide attempts). Results The three groups statistically differed with regard to lifetime suicide attempts (p ?0.01). More patients with mood (42.5%) and schizophrenia spectrum disorders (35.7%) reported lifetime suicide attempts compared to patients with anxiety disorders (0%). In all groups, self-poisoning was the most common method for suicide attempts. There was a significant difference among the diagnostic groups in the intensity of suicidal motivation (p 0.05) and suicidal preparation (p> 0.05). Patients with mood disorders scored higher on the intensity of suicidal motivation compared to patients with schizophrenia spectrum. Conclusion The risk of lifetime suicide attempts was highest in patients with mood disorders, as well as intensity of suicidal motivation.

Cognitive function and suicide risk in Han Chinese inpatients with schizophrenia

The lifetime risk of suicide in patients with schizophrenia is estimated to be 4.9–13%. While there are many known risk factors for suicide in schizophrenia, the relationship between cognitive function and suicide risk is unclear, particularly in non-Caucasian populations. In our cross-sectional study, we administered the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) to 316 Han Chinese chronic inpatients with schizophrenia and compared the performance of those who had attempted suicide (n=25) to non-attempters (n=291). The lifetime suicide attempt data were collected from medical records and interviews with patients and their family members. We found a lifetime suicide attempt rate of 7.9%. Suicide attempters were more likely to be single, but showed no significant differences in other demographic factors such as age, gender, or living arrangements. Contrary to our hypothesis, there was no significant relationship between performance on the RBANS test and lifetime risk of suicide attempts in Han Chinese inpatients with schizophrenia. The literature remains mixed on this topic. Culturally influenced differences in suicidal behavior may have affected the outcome of this study and further investigation of this topic is necessary.

Association between childhood adversities and long-term suicidality among South Africans from the results of the South African Stress and Health study: a cross-sectional study

ObjectiveSuicide and suicidal behaviours are significant public health problems and a leading cause of death worldwide and in South Africa. We examined the association between childhood adversities and suicidal behaviour...

The influence of parental divorce and alcohol abuse on adult offspring risk of lifetime suicide attempt in the United States.

The influences of parental divorce and alcohol abuse on adult offspring lifetime suicide attempt have not been examined in national data. This study analyzed data from the 2001-2002 NESARC to estimate main and interaction effects of parental divorce and alcohol abuse on lifetime suicide attempt. Adjusted for controls, parental divorce and parental alcohol abuse independently increased odds of lifetime suicide attempt. The effect of parental divorce was not significantly moderated by parental alcohol abuse. Further research is needed to examine whether additional parental and offspring psychiatric and substance use covariates attenuate the association between parental divorce and lifetime suicide attempt.

Risk factors for suicide attempts in the total population of Faroese eighth graders

Abstract Objectives: Suicide is still one of the leading causes of youth mortality, and amongst others previous suicide attempts have been found to be one of the strongest risk factors for suicide. The objective of this study is to examine risk factors of suicide attempts in a total population of Faroese adolescents. It is expected that anxious attachment, high scores on negative affectivity and low scores on past and present social support were correlated to an increased risk of life-time suicide attempts in both female and male adolescents. Method: Analyses were conducted based on data from The Faroese Adolescent Trauma Study, a self-report questionnaire survey including a total population of Faroese eighth graders (N = 687; 85 % response rate, mean age 14.2 years, SD = 2.1). The questionnaire included The Revised Adult Attachment Scale (RAAS), The Trauma Symptom Checklist (TSC), and The Crisis Support Scale (CSS). Results: In the total population 9.9 % (N = 68) of the participants reported life-time suicide attempt; of those 28 % were boys and 72 % were girls. In line with the expectations, the initial comparison showed that adolescents reporting life-time suicide attempt had significantly higher scores on attachment anxiety and negative affectivity, and had significantly lower scores on attachment closeness, and both past and present social support. Further analyses stratified on gender, however, revealed unexpected results, as a high score on negative affectivity only was a significant risk factor for life-time suicide attempt among the girls, and high score on attachment closeness only was a significant protective factor of life-time suicide attempt among the boys. Conclusions: This study provides important data about the role of attachment, negative affectivity, and social support in suicide attempts in a total population of Faroese adolescents. Moreover the results show the necessity of taking gender into account in research of risk and protective factors of suicide attempts, and when establishing arrangements to prevent and treat suicide attempts in adolescents.

Association Between Childhood Adversities and Suicide Attempts Among Alcoholic Inpatients in Taiwan

Alcohol dependence is frequently associated with suicide attempts. A history of adverse childhood experiences (ACEs) increases the risk of emotional and behavioral problems in adulthood. Child abuse is reported to increase suicide risk among alcohol-dependent patients. However, other types of ACEs, including ACEs related to family dysfunction that may have exceptional impact among the Chinese, are rarely explored. The contribution of a broad spectrum of ACEs to lifetime risk of suicide attempts among alcoholic inpatients in Taiwan was examined. Family Health History Questionnaires were used to assess ACEs among 194 male alcohol-dependent inpatients admitted for alcohol detoxification. Logistic regression analysis was applied to examine the prediction of ACEs for lifetime risk of suicide attempts. The rate of attempted suicide in this cohort was 27.4%. The prevalence of ACEs was high, with around 90% of participants reporting at least one type of ACE. In the regression analysis, after adjusting for lifetime depression, illicit drug use, and severity of alcohol dependence, having had a battered mother (odds ratio [OR] = 3.99, 95% CI [1.40, 11.34]) and having parents who were separated/divorced (OR = 7.35, 95% CI [1.56, 34.72]) were associated with the risk of suicide attempts, but having experienced physical and sexual abuse were not. A 1-unit increase in childhood adversity raised the likelihood of a suicide attempt by 61% (OR = 1.61, 95% CI [1.16, 2.25]). There is a direct and graded relationship between childhood adversities and lifetime risk of suicide attempts among male alcoholic patients. In Chinese societies, adversities related to parental separation, divorce, and interparental violence may have a specific effect in aggravating suicide risk.

Childhood Exposure to Caregiver Suicidal Behavior and Risk for Adult Suicide Attempts: Findings from a National Survey

The objective of this study was to investigate the association between exposure to caregiver suicidality and subsequent adult suicide attempt (SA). Data came from the National Epidemiologic Survey on Alcohol and Related Conditions Wave 2 (n = 34,653). Respondents were asked if they had a caregiver attempt or complete suicide during childhood. Logistic regression examined associations between SA and caregiver suicidality. Compared to individuals with no suicidality, risk for lifetime SA was higher for individuals that were exposed to a SA (15.6%, [OR] = 5.86, 95% [CI] = 4.57–7.51) and for those who experienced a death by suicide (6.1%, [OR] = 2.08, CI = 1.32–3.26]. Associations remained significant after controlling for demographics, Axis I and II disorders and childhood adversity. Individuals with exposure to suicidality are at increased odds for SA.

Sexual Orientation Minorities in College Counseling: Prevalence, Distress, and Symptom Profiles

Sexual minority group members are at a higher risk for mental health difficulties than are heterosexual individuals. The results of this study showed that college student sexual minorities were common in counseling centers and that they were more likely than heterosexual students to seek counseling. The results also showed that sexual orientation groups differed in meaningful ways from one another, and many sexual orientation groups reported higher levels of psychological symptoms than did heterosexual students.

Impulsivity and borderline personality as risk factors for suicide attempts among opioid-dependent individuals

The study aimed to examine the association of impulsivity and screening positively for borderline personality disorder (BPD+) as risk factors for suicide attempts among opioid-dependent individuals. The study used a case-control design with 775 opioid-dependent cases and 306 non-opioid-dependent controls. Cases were more likely than controls to screen BPD+ and to be classed as highly impulsive. Significant risk for lifetime suicide attempt was associated with screening BPD+ and also with high impulsivity. A number of risk factors were identified for suicide attempts among those with either high impulsivity or among those who screened BPD+: being female, a diagnosis of an anxiety disorder and a diagnosis of illicit drug dependence (other than opioid dependence). Opioid dependence was not a unique risk factor for suicide attempts among either the BPD+ group or the high impulsivity group. Although opioid dependence was not a unique risk factor for suicide attempts among those who screened BPD+, cases presented with multiple risk factors at substantially higher rates than controls. This research also highlights the importance of assessing impulsivity, in both clinical settings and research, particularly among those with a history of suicidal behaviour.