Lower Suicide Risk Research Articles

Pet Attachment and the Interpersonal Theory of Suicide.

Background: Pet ownership is often assumed to have mental health benefits, but the effect of pets on suicide risk has a scant literature. Aims: Using the interpersonal theory of suicide, we examined the relationships between perceived burdensomeness (PB), thwarted belongingness (TB), overall attachment to one's pet, pet attachment avoidance or anxiety, and suicide risk. The following three hypotheses were investigated: (1) Higher attachment would be indirectly associated with lower suicide risk via lower TB and lower PB; (2) attachment would be associated with higher suicide risk, as conditioned on attachment avoidance/anxiety; and (3) attachment avoidance/anxiety would be associated with higher suicide risk via higher TB/PB. Method: Undergraduates (N = 187) completed surveys, and indirect effect and conditional effect analyses were utilized. Results: Overall attachment was associated with lower PB, which was associated with lower suicide risk. The relationship between overall attachment and suicide risk was not conditional upon attachment anxiety/avoidance. Attachment avoidance was associated with increased levels of TB, which was associated with increased suicide risk. Attachment anxiety was associated with increased suicide risk via TB and PB. Limitations: We used a university sample that had limited access to pets. Conclusions: Findings suggest that pet ownership may provide mixed associations with suicide risk.

Distant Supervision for Mental Health Management in Social Media: Suicide Risk Classification System Development Study.

BackgroundWeb-based social media provides common people with a platform to express their emotions conveniently and anonymously. There have been nearly 2 million messages in a particular Chinese social media data source, and several thousands more are generated each day. Therefore, it has become impossible to analyze these messages manually. However, these messages have been identified as an important data source for the prevention of suicide related to depression disorder.ObjectiveWe proposed in this paper a distant supervision approach to developing a system that can automatically identify textual comments that are indicative of a high suicide risk.MethodsTo avoid expensive manual data annotations, we used a knowledge graph method to produce approximate annotations for distant supervision, which provided a basis for a deep learning architecture that was built and refined by interactions with psychology experts. There were three annotation levels, as follows: free annotations (zero cost), easy annotations (by psychology students), and hard annotations (by psychology experts).ResultsOur system was evaluated accordingly and showed that its performance at each level was promising. By combining our system with several important psychology features from user blogs, we obtained a precision of 80.75%, a recall of 75.41%, and an F1 score of 77.98% for the hardest test data.ConclusionsIn this paper, we proposed a distant supervision approach to develop an automatic system that can classify high and low suicide risk based on social media comments. The model can therefore provide volunteers with early warnings to prevent social media users from committing suicide.

Incidence of suicide mortality among childhood cancer survivors: A population-based retrospective study

The aim of our study was to investigate the suicide rates among childhood cancer survivors and assess factors associated with higher suicide risk. A review of data from Surveillance, Epidemiology, and End Results (SEER) program from 1975 to 2016 was performed for this study. This program is based on the US population and is supported by the US National Cancer Institute (NCI). Survivors diagnosed with childhood cancer were recorded. There were 40 suicides among 567,233 person-years, giving a suicide rate of 7.1 per 100,000 person-years. Compared with cancer diagnosed between 10 and 14 years old, survivors with cancer diagnosed between 0 and 4 years old had lower suicide risk. Females had a lower risk of suicide than males. Compared with survivors of thyroid cancer, the aHRs were 0.16 for acute lymphocytic leukemia, 0.15 for nodal Hodgkin's lymphoma, 0.14 for brain cancers and 0.09 for kidney cancers. Most suicides occurred after 15 years old. Suicide was a problem for survivors, especially those with thyroid cancer. Beside treating patients holistically, early psychological interventions such as communicating effectively, providing social support and follow-up care related to psychological health are needed.

Marital status, educational attainment, and suicide risk: a Norwegian register-based population study

BackgroundThe presence and quality of social ties can influence suicide risk. In adulthood, the most common provider of such ties is one’s partner. As such, the link between marital status and suicide is well-documented, with lower suicide risk among married. However, the association between marital status and educational level suggest that marriage is becoming a privilege of the better educated. The relationship between educational attainment and suicide is somewhat ambiguous, although several studies argue that there is higher suicide risk among the less educated. This means that unmarried with low education may concurrently experience several risk factors for suicide. However, in many cases, these associations apply to men only, making it unclear whether they also refer to women. We aim to investigate the association between marital status, educational attainment, and suicide risk, and whether these associations differ across sexes.MethodsOur data consist of Norwegian residents aged 35–54, between 1975 and 2014. Using personal identification-numbers, we linked information from various registers, and applied event history analysis to estimate suicide risk, and predicted probabilities for comparisons across sexes.ResultsOverall, associations across sexes are quite similar, thus contradicting several previous studies. Married men and women have lower suicide risk than unmarried, and divorced and separated have significant higher odds of suicide than never married, regardless of sex. Low educational attainment inflates the risk for both sexes, but high educational attainment is only associated with lower risk among men. Being a parent is associated with lower suicide risk for both sexes.ConclusionsHigher suicide risk among the divorced and separated points to suicide risk being associated with ceasing of social ties. This is the case for both sexes, and especially those with low educational attainment, which both healthcare professionals and people in general should be aware of in order to promote suicide prevention.

Social closeness and support are associated with lower risk of suicide among U.S. Army soldiers.

We tested the aspects of social support, unit cohesion, and religiosity hypothesized to be protective factors for suicide among U.S. service members. This case-control study compared U.S. Army soldiers who died by suicide while on active duty (n=135) to controls of two types: those propensity score-matched on known sociodemographic risk factors (n=128); and those controls who had thought about, but not died by, suicide in the past year (n=108). Data included structured interviews of next of kin (NOK) and Army supervisors (SUP) for each case and control soldier. Logistic regression analyses were used to examine predictors of suicide. Perceived social closeness and seeking help from others were associated with decreased odds of suicide, as reported by SUP (OR=0.2 [95% CI=0.1, 0.5]) and NOK (OR=0.4 [95% CI=0.2, 0.8]). Novel reports by SUP informants of high levels of unit cohesion/morale decreased odds of suicide (OR=0.1 [95% CI=0.0, 0.2]). Contrary to study hypotheses, no religious affiliation was associated with lower odds of suicide (OR=0.3 [95% CI=0.2, 0.6]). Perceived social closeness and unit/group cohesion are associated with lower odds of suicide. These results point toward social intervention strategies as testable components of suicide prevention programs.

Analysis of psycho-sociodemographic features in referred male psychiatric patients with suicidal ideation

Abstract Suicide is defined by the World Health Organization as an act in which an individual ends his or her own life. Suicidal behavior is a major public health problem worldwide. According to the World Health Organization, the global suicide rate is 10,5/100.000 – 13,5/100.000 in case of men and 7,7/100 000 in case of women and is the 2nd most common cause of violent death. Suicide is a multifactorial phenomenon that can be approached from different perspectives. In Romania, this rate is similar to the global rate: in 2016, the estimated suicide rate was 10.4/100,000, well below the European average. Suicide rates vary by region, age group, gender, ethnicity, and registration of mortality statistics. The aim of the present study is to investigate the psycho-socio-demographic indicators of a cohort of patients with suicidal thoughts emergency referred to a particular psychiatric ward in one year. In our research, we performed a case-control, analytical, randomized, observational study at the Clinical Hospital of Neurology and Psychiatry Brasov among adult psychiatric patients admitted during 2014. The following data on patients were processed: demographic data (age, gender, place of residence), psychosocial data (social background, marital status, education), chronic somatic comorbidities, family history of psychiatric illness, pre-existing psychiatric illnesses, previous suicide attempts and their characteristics. The risk of suicide was assessed by the Modified Scale for Suicide Ideation - Miller et al. Questionnaire and distinguished 3 categories. In our sample of 77 cases we identified 14 patients with low suicide risk, 17 with moderate risk and 46 with high suicide risk. The focus of our study was on suicidal behavior. Suicide attempt, as a complex clinical problem with a waste complexity of ethiology, has high demands on psychiatric care. Being familiar with the different psycho-socio-demographic profiles by gender is proved to be a useful tool in both “screening” and in subsequent case management. These principles can facilitate decision-making, can increase adherence to treatment, and reduce the risk of repetitive attempts.

Association of Opioid Agonist Treatment With All-Cause Mortality and Specific Causes of Death Among People With Opioid Dependence

Mortality among people with opioid dependence is higher than that of the general population. Opioid agonist treatment (OAT) is an effective treatment for opioid dependence; however, there has not yet been a systematic review on the relationship between OAT and specific causes of mortality. To estimate the association of time receiving OAT with mortality. The Embase, MEDLINE, and PsycINFO databases were searched through February 18, 2020, including clinical trial registries and previous Cochrane reviews. All observational studies that collected data on all-cause or cause-specific mortality among people with opioid dependence while receiving and not receiving OAT were included. Randomized clinical trials (RCTs) were also included. This systematic review and meta-analysis followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. Data on study, participant, and treatment characteristics were extracted; person-years, all-cause mortality, and cause-specific mortality were calculated. Crude mortality rates and rate ratios (RRs) were pooled using random-effects meta-analyses. Overall all-cause and cause-specific mortality both by setting and by participant characteristics. Methadone and buprenorphine OAT were evaluated specifically. Fifteen RCTs including 3852 participants and 36 primary cohort studies including 749 634 participants were analyzed. Among the cohort studies, the rate of all-cause mortality during OAT was more than half of the rate seen during time out of OAT (RR, 0.47; 95% CI, 0.42-0.53). This association was consistent regardless of patient sex, age, geographic location, HIV status, and hepatitis C virus status and whether drugs were taken through injection. Associations were not different for methadone (RR, 0.47; 95% CI, 0.41-0.54) vs buprenorphine (RR, 0.34; 95% CI, 0.26-0.45). There was lower risk of suicide (RR, 0.48; 95% CI, 0.37-0.61), cancer (RR, 0.72; 95% CI, 0.52-0.98), drug-related (RR, 0.41; 95% CI, 0.33-0.52), alcohol-related (RR, 0.59; 95% CI, 0.49-0.72), and cardiovascular-related (RR, 0.69; 95% CI, 0.60-0.79) mortality during OAT. In the first 4 weeks of methadone treatment, rates of all-cause mortality and drug-related poisoning were almost double the rates during the remainder of OAT (RR, 2.01; 95% CI, 1.55-5.09) but not for buprenorphine (RR, 0.58; 95% CI, 0.18-1.85). All-cause mortality was 6 times higher in the 4 weeks after OAT cessation (RR, 6.01; 95% CI, 4.32-8.36), remaining double the rate for the remainder of time not receiving OAT (RR, 1.81; 95% CI, 1.50-2.18). Opioid agonist treatment was associated with a lower risk of mortality during incarceration (RR, 0.06; 95% CI, 0.01-0.46) and after release from incarceration (RR, 0.09; 95% CI, 0.02-0.56). This systematic review and meta-analysis found that OAT was associated with lower rates of mortality. However, access to OAT remains limited, and coverage of OAT remains low. Work to improve access globally may have important population-level benefits.

A brief reflection on the role of cholesterol in psychopathology among female psychiatric patients

Abstract Objective: Cholesterol is one of the cardiovascular risk factors, but also a core component of the central nervous system. Moreover, hyper-cholesterolemia and hypocholesterolemia are directly related to numerous mental illnesses too. This study intents to examine the association between cholesterol level and autolytic behavior among female psychiatric patients. Methods: The present study involves 123 female subjects, who suffered from suicidal thoughts at the moment of hospitalization. The risk of suicidal intentions was assessed by the Modified Scale for Suicide Ideation (Miller et al) and their total serum cholesterol levels were measured. We performed a case-control, analytical, randomized, observational study at the Clinical Hospital of Neurology and Psychiatry Brasov among adult female psychiatric patients admitted during 2014. Results: By our results we distinguished 3 categories: 38 patients with low suicide risk, 32 with moderate risk and 53 with high suicide risk. Significant difference can be noticed in the higher suicide risk patients’ blood cholesterol levels: 44 patients having under 4,5mmol/L total cholesterol level (83%). Although, in other two categories, this proportion is minimal: in the moderate-risk category were 8 patients, representing just 25 %, and in the low-risk category only 1 patient had her cholesterol level under 4,5mmol/L (2,6%). Conclusions: According to our results, proposing cholesterol-level as a biomarker for the determination of high-risk suicide behavior can be important. The presence of other important risk factors (sociodemographic and psychiatric variables) can increase exponentially the suicide behavior. The limitations of this study are the relatively small number of cases and the lack of longitudinal subsequent follow-up. Further investigations are needed on a larger and more heterogenous sample of patients in order to clarify this suggestive correlation.

The Suicide Prevention, Depression Awareness, and Clinical Engagement Program for Faculty and Residents at the University of California, Davis Health.

ObjectiveThe objective of the study is to present results of a depression and suicide screening and treatment referral program for physicians at an academic medical center.MethodsAn anonymous web-based screening questionnaire was sent to all physicians at a large academic center. Responses were classified as indicating either high, moderate, or low risk for depression and suicide. Physicians at high and moderate risk were contacted by a counselor through a messaging system. The counselor’s message contained information on risk level and an invitation to meet in person. High-risk respondents who did not reply to the message or declined to meet received mental health resources. Respondents who met with the counselor were offered individualized treatment referrals and to participate in a 1-year follow-up of self-reports every 3 months.ResultsThe questionnaire was sent to approximately 1800 residents, fellows, and faculty from February 2013 through March 2019. A total of 639 questionnaires were received, 100 were excluded for various reasons, and 539 were used to conduct analyses (14.4% response rate). The majority of respondents were classified at moderate (333 [62%]) or high (193 [36%]) risk for depression or suicide. Eighty-three respondents were referred for mental health care, and 14 provided data for the follow-up study.ConclusionsResults of screening physicians for depression and suicide at one academic medical center highlight the challenges of engaging most of them in this activity and the satisfaction of the minority who successfully engaged in a treatment referral program.

Association Between Stroke and Subsequent Risk of Suicide: A Systematic Review and Meta-Analysis.

Poor mental health and depression are well-recognized sequelae of stroke; however, the association between stroke and subsequent risk of suicide is unknown. We systematically searched MEDLINE, Embase, PsycINFO, and Google Scholar from their inception to September 15, 2020, using keywords and database-specific subjects. We independently adjudicated and selected observational studies that reported suicide attempts or death by suicide in stroke survivors and a comparison group, consisting either of people without a history of stroke or the general population. We evaluated study quality using the Newcastle Ottawa scale. Using random-effects meta-analysis, we calculated the pooled adjusted risk ratio (RR) of suicide in stroke survivors and separately calculated the pooled adjusted RR of suicide attempt and death by suicide. Using prespecified analyses, we explored study-level factors to explain heterogeneity. We screened 4093 articles and included 23 studies of fair quality, totaling over 2 million stroke survivors, of whom 5563 attempted suicide or died by suicide. Compared to the nonstroke group, the pooled adjusted RR of suicide in stroke survivors was 1.73 (95% CI, 1.53-1.96, I2=93%), with a significantly (P=0.03) higher adjusted risk of suicide attempt (RR, 2.11 [1.73-2.56]) than of death by suicide (RR, 1.61 [1.41-1.84]). A longer follow-up time in cohort studies was associated with a lower risk of suicide (RR, 0.97 [0.95-0.99] for every 1-year increase). Stroke should be considered as a risk factor for suicide. Comprehensive strategies to screen and treat depression and suicidal ideation in stroke survivors should be developed to reduce the burden of suicide in stroke survivors.

Suicide Risk and Addiction: The Impact of Alcohol and Opioid Use Disorders.

Purpose of ReviewSuicide is a major public health concern and a leading cause of death in the US. Alcohol and opioid use disorders (AUD/OUD) significantly increase risk for suicidal ideation, attempts, and death, and are the two most frequently implicated substances in suicide risk. We provide a brief overview of shared risk factors and pathways in the pathogenesis of AUD/OUD and suicidal thoughts and behaviors. We also review clinical recommendations on inpatient care, pharmacotherapy, and psychotherapeutic interventions for people with AUD/OUD and co-occurring suicidal ideation and behavior.Recent FindingsAmong people with an underlying vulnerability to risk-taking and impulsive behaviors, chronic alcohol intoxication can increase maladaptive coping behaviors and hinder self-regulation, thereby increasing the risk of suicide. Additionally, chronic opioid use can result in neurobiological changes that lead to increases in negative affective states, jointly contributing to suicide risk and continued opioid use. Despite significantly elevated suicide risk in individuals with AUD/OUD, there is a dearth of research on pharmacological and psychosocial interventions for co-occurring AUD/OUD and suicidal ideation and behavior.SummaryFurther research is needed to understand the effects of alcohol and opioid use on suicide risk, as well as address notable gaps in the literature on psychosocial and pharmacological interventions to lower risk for suicide among individuals with AUD/OUD.

Preterm birth, low fetal growth and risk of suicide in adulthood: a national cohort and co-sibling study.

Adverse perinatal exposures have been associated with psychiatric disorders and suicidal behaviours later in life. However, the independent associations of gestational age at birth or fetal growth with suicide death, potential sex-specific differences, and causality of these associations are unclear. A national cohort study was conducted of all 2440518 singletons born in Sweden during 1973-98 who survived to age 18 years, who were followed up through 2016. Cox regression was used to compute hazard ratios (HRs) for suicide death associated with gestational age at birth or fetal growth while mutually adjusting for these factors, sociodemographic characteristics and family history of suicide. Co-sibling analyses assessed the influence of unmeasured shared familial (genetic and/or environmental) factors. In 31.2 million person-years of follow-up, 4470 (0.2%) deaths by suicide were identified. Early preterm birth (22-33 weeks) was associated with an increased risk of suicide among females [adjusted hazard ratio (HR), 1.97; 95% confidence interval CI), 1.29, 3.01; P = 0.002) but not males (0.90; 0.64, 1.28; P = 0.56), compared with full-term birth (39-41 weeks). Small for gestational age was associated with a modestly increased risk of suicide among females (adjusted HR, 1.27; 95% CI, 1.08, 1.51; P = 0.005) and males (1.14; 1.03, 1.27; P = 0.02). However, these associations were attenuated and non-significant after controlling for shared familial factors. In this large national cohort, preterm birth in females and low fetal growth in males and females were associated with increased risks of suicide death in adulthood. However, these associations appeared to be non-causal and related to shared genetic or prenatal environmental factors within families.

Visual memory improvement in adolescents at high risk for suicide who are receiving psychotherapy at a community clinic

The current study aims to: 1) investigate cognitive differences among adolescents at risk for suicide versus healthy controls (HC) and 2) identify cognitive changes associated with response to psychotherapy among adolescents at high risk for suicide. Thirty-five adolescents at high risk for suicide (HR), and 14 HC adolescents were recruited. Clinical and cognitive assessments were conducted in both groups at baseline and 16 weeks later (after the patients completed psychotherapy). HR and HC adolescents were compared at baseline and at completion of the study. We also conducted further analysis by separating into two groups the HR adolescents who responded to psychotherapy (n=17) and those who did not (n=11). At baseline, the HR group had significantly lower performance on verbal memory and processing speed than the HC group. At week 16, HR adolescents performed as well as HC adolescents in all cognitive domains. Among patients, better performance on visual memory was observed in those who responded to psychotherapy compared to those who did not. We concluded that lower performance on verbal memory and processing speed may be associated with a high risk for suicide among adolescents. Improvement in visual memory might be related to a lower risk for suicide in adolescents.

Suicide risk assessment in a large public mental health service: do suicide risk classifications identify those at risk?

Risk assessment tools are routinely used to identify patients at high risk. There is increasing evidence that these tools may not be sufficiently accurate to determine the risk of suicide of people, particularly those being treated in community mental health settings. An outcome analysis for case serials of people who died by suicide between January 2014 and December 2016 and had contact with a public mental health service within 31 days prior to their death. Of the 68 people who had contact, 70.5% had a formal risk assessment. Seventy-five per cent were classified as low risk of suicide. None were identified as being at high risk. While individual risk factors were identified, these did not allow to differentiate between patients classified as low or medium. Risk categorisation contributes little to patient safety. Given the dynamic nature of suicide risk, a risk assessment should focus on modifiable risk factors and safety planning rather than risk prediction. The prediction value of suicide risk assessment tools is limited. The risk classifications of high, medium or low could become the basis of denying necessary treatment to many and delivering unnecessary treatment to some and should not be used for care allocation.

Evaluation of suicide risk in medical students

OBJECTIVES: Suicide is considered a serious public health problem and especially affects medical students, who present a high prevalence of suicidal ideation, of approximately 11.1%. The aim of this study is to evaluate the risk of suicide in medical students from a University in an inland city of the State of São Paulo, Brazil.METHODS: This is a cross-sectional study carried out with 169 medical students from stages I, II, III and V of the medical course. Two questionnaires were employed: the module C of the Mini International Neuropsychiatric Interview (MINI), in which the risk of suicide was classified as “low” or “moderate/high”; and a survey with 23 questions about clinical and demographic factors potentially associated with suicide risk. A preliminary exploratory analysis was carried out to investigate this association and a subsequent logistic regression was employed to perform a multivariate analysis.RESULTS: of the students who responded to the MINI questionnaire, 131 (77.5%) showed a low risk of suicide and 37 (21.9%), a moderate/high risk. The variables that were associated with suicide risk were: family history of suicide (RR= 5.90; p=0.001) and the diagnosis of mental disorders (RR=3.96; p= 0.004). Alcohol consumption was associated with suicide risk in the preliminary bivariate analysis (RR=4; p=0.046), but this association did not remain significant in the final model of the multivariate analysis (RR=3.54; p=0.059).CONCLUSION: The results showed that a family history of suicide and the diagnosis of mental disorders were associated with suicide risk and can be used to identify students at risk, as well as to guide preventive strategies for its prevention in Medical Schools.

Electrodermal activity and suicide risk assessment in patients with affective disorders.

There are questionnaires and scales, including self-assessment scales, used to evaluate suicide risk. Additionally, suicide risk factors (i.a., prior suicide attempts, willingness to commit suicide, somatic diseases, male gender) are also known. Their application, however, does not provide a sufficient guarantee for properly distinguishing persons with high and low suicide risk. In 1986, Gunnar Edman observed that there is an association between low electrodermal activity and suicidal tendencies, which was confirmed in other studies and meta-analyses. Electrodermal activity (EDA) is commonly considered to be a very good indicator of orienting reflex, which is a response to the information linked with a stimulus and, in a way, a physiological mechanism that helps an organism to survive. This phenomenon is related to habituation, the rate of which is a measure of EDA reactivity. Hyporeactivity consists in very rapid habituation of a stimulus, even after first exposure. According to Lars Håkan Thorell, hyporeactivity may be understood as a specific deficit of attention, which is associated with inability to arouse curiosity with ordinary, everyday events at the physiological level. This results in a greater tendency to attempt suicide shown by persons with mood disorders, and lower fear of hurting oneself. The goal of this paper is to present history of studies on electrodermal activity, relationship between EDA and suicide tendencies in persons with affective disorders and to discuss EDOR System that identifies persons at particularly high risk of committing suicide.

Clozapine and mortality: A comparison with other antipsychotics in a nationwide Danish cohort study.

ObjectiveTo compare the mortality in people using clozapine to that of people using other antipsychotics.MethodsDanish incidence cohort of 22,110 patients with a first diagnosis of non‐affective psychotic disorder (1995–2013) and a prevalence cohort of 50,881 patients ever diagnosed with such a disorder (1969–2013). Hazard ratios (HR) were calculated for the antipsychotic drug used at the time of death (“current use”: incidence and prevalence cohort) and for the drug used for the longest at that moment (“cumulative use”: incidence cohort), using a Cox model with adjustment for somatic comorbidity. Clozapine was the reference drug.ResultsAs for current drug use, the risk of suicide was higher among users of other antipsychotics in the incidence (HRadj = 1.76; 95% CI 0.72–4.32) and prevalence (HRadj = 2.20; 95% CI 1.35–3.59) cohorts. There was no significant difference in all‐cause or cardiovascular mortality in the two cohorts. Cumulative use of clozapine was not associated with an increased cardiovascular mortality. Cumulative use of other antipsychotics for up to 1 year was associated with a lower all‐cause mortality and suicide risk than a similar period of clozapine use (all‐cause: HRadj = 0.73; 95% CI 0.63–0.85, suicide; HRadj = 0.65; 95% CI 0.46–0.91).ConclusionThe results indicate that the use of clozapine is not associated with increased cardiovascular mortality. We found opposing trends toward a lower risk of suicide during current use of clozapine and a higher risk of suicide associated with cumulative use up to 1 year. This suggests that clozapine cessation marks a period of high risk of suicide.

Social Problem-Solving and Suicide Risk Across the Lifespan: A Qualitative Investigation

Social disconnectedness, or thwarted belongingness (TB) is a risk factor for suicide across the lifespan. Perceived time left (PTL) to live may impact perceptions of hopefulness for future social connectedness, and thus the generation of problem-solving strategies for decreasing TB and the risk for suicide. We conducted an exploratory analysis of the quantity and quality of older and younger adults’ recommendations for decreasing TB of characters in vignettes who were depicted as having high or low TB (i.e., described as lonely or not lonely) and high or low PTL (i.e., described as being 35-years-old or 85-years-old). We also examined the relation between participants’ social recommendations and suicide risk. Participants with higher suicide risk endorsed higher hopelessness on the High TB/Low PTL vignette and were more likely to recommend contact with family as a means of reducing TB (χ^2(1) = 4.25, p = 0.04) than were participants with lower suicide risk. Participants with higher suicide risk were also more likely to recommend social activity with friends than were participants with lower suicide risk on the High TB/High PTL vignette, (χ^2(1) = 6.66, p = 0.01) and on the High TB/Low PTL vignette (χ^2(1) = 6.14, p = 0.02). Additionally, age differences were observed such that older participants made fewer recommendations involving socializing with family and friends than did younger adults, and provided more nonsocial or made no recommendations across vignettes. The results suggest that social problem-solving may be an important differentiating variable among older and younger adults at risk for suicide.

The Developmental Context of Social Hopefulness and Suicide Risk

Social disconnectedness, or thwarted belongingness (TB) has been documented as an important risk factor for suicide across the lifespan. Perceived time left (PTL) may impact perceptions of hopelessness for social connectedness and therefore inform developmentally sensitive trajectories of suicide risk. This study examined interpersonal conditions associated with social hopelessness in younger and older adults in order to identify variables important for conceptualizing suicidality across the lifespan. We compared younger and older adults’ perceptions of social hopelessness for characters in vignettes that were depicted as having high or low TB (i.e., described as lonely or not lonely) and high or low PTL (i.e., described as being 35-years-old or 85-years-old). Additionally, we examined the relation between social hopelessness and suicide risk (using the Suicide Behaviors Questionnaire—Revised). Participants included 135 younger (M = 19.32) and 69 older (M = 74.91) adults. Older adults endorsed less social hopelessness than did younger adults on the High TB/Low PTL vignette, t(102.15) = -4.88, p < 0.001, as well as the Low TB/Low PTL vignette, t(194) = -2.04, p = 0.04. Participants with higher suicide risk also endorsed higher social hopelessness on the High TB/Low PTL vignette than did participants with lower suicide risk, t(194) = -2.10, p = 0.04. Younger adults and participants with higher suicide risk across both age groups reported less optimism for characters’ future social connectedness, particularly for those portrayed as older. This study provides support for the importance of developmentally informed conceptualizations of risk factors for suicide, including social hopelessness.

Suicide Prevention Public Service Announcements.

Background: Suicide prevention public service announcements (PSAs) help to disseminate information about suicide and help-seeking options. However, little is known about how individuals at risk for suicide recall PSAs. Aims: The current project assessed which features of suicide prevention PSAs are recalled by young adult participants and whether there are differences between those who are at low or high risk for suicide. Method: Participants (N = 140) viewed a simulated suicide prevention billboard that consisted of a main message, help-seeking message, and graphical features. Participants provided written recollections of the billboard features approximately 15 min post-viewing, which were coded and analyzed. Results: High-risk participants were significantly less likely than low-risk participants to include a description of the help-seeking message in their written recall. Few group differences were noted in the recall of the main message or graphical features. Limitations: Recall was limited to short-term recall based on a single exposure. Efforts to enhance internal validity (e.g., measurement of suicide risk) and external validity (e.g., a balanced sample regarding sex and race) are recommended. Conclusions: Results suggest that new tactics may need to be considered when developing suicide prevention messages, including crafting help-seeking messages that are more easily committed to memory for target audiences.