Predictors Of Suicidal Ideation Research Articles

Examining Risk Factors in the Cannabis-Suicide Link: Considering Trauma and Impulsivity among University Students.

Cannabis is a commonly used substance among university students that may have several negative health repercussions, including suicidal ideation (SI) and suicide attempts (SA). The factors that contribute to or help explain this relation remain uncertain. Earlier negative experiences, especially trauma encountered during early life, have been associated with the development of psychopathology upon later stressor encounters. In the current study, we examined the associations between SI and SA with problematic cannabis use among young adults and the role of earlier trauma experiences and trait impulsiveness in understanding this link. Among university students (N = 539), problematic cannabis use was moderately related to lifetime and past-12-months suicidal ideation and attempts. Impulsiveness mediated the relationship between problematic cannabis use and lifetime SI and SA. Moreover, previous life trauma moderated the relationship between problematic cannabis use and SA, such that the association between problematic cannabis use and SA was stronger among those who experienced high levels of trauma. These findings highlight behavioral and environmental factors that could predict suicide ideation and attempts among young cannabis users. Accordingly, trait impulsiveness and early trauma experiences should be considered, alongside problematic cannabis use, in suicide-risk detection and prevention strategies among young adults.

Predictors of Suicidal Ideation and Preparatory Behaviors in Individuals With Bipolar Disorder: The Contribution of Chronobiological Dysrhythmicity and Its Association With Hopelessness

Predictors of Suicidal Ideation and Preparatory Behaviors in Individuals With Bipolar Disorder: The Contribution of Chronobiological Dysrhythmicity and Its Association With Hopelessness

Reasons for living, positive psychological constructs and their relationship with suicide ideation in people with moderate to severe traumatic brain injury: A cross-sectional study

ABSTRACT Positive psychological constructs such as reasons for living, self-esteem and resilience have previously been shown to act as protective psychological barriers against negative psychological outcomes, including suicide ideation in both clinical populations and the general population. This study aims to explore the positive psychological constructs of reasons for living, self-esteem, resilience and their relationship with suicide ideation and predictors of suicide ideation (depression, hopelessness) for N = 50 people who have a severe TBI and are currently receiving community rehabilitation at Liverpool Brain Injury Rehabilitation Unit (LBIRU), NSW. Results indicated good reliability for the use of the RFLI with people who have TBI, with the most frequently endorsed subscale (range 0–5) being “survival and coping beliefs” (4.7 ± 1.0) and the least frequently being “fear of suicide” (2.2 ± 1.1). The shortened version of the RFLI (BRFLI) also displayed good reliability. Positive psychological constructs (reasons for living, resilience, self-esteem) were all significantly inversely associated with suicide and suicide predictors (depression, hopelessness). This study suggests that positive psychological constructs can act as a buffer against suicide ideation after moderate to severe TBI.

The Prediction of Suicidal Ideation as a Function of Daily Mood and Anxiety Scores Collected Using mHealth Technology in Patients Undergoing Treatment for Depression

Background Suicide is one of the most common causes of death in the United States. The rates of suicide have increased by 33% in the period 1999-2019. In 2019, suicide was responsible for one death every 11 minutes. Clinically, a previous history of suicide attempts is the main risk factor, as well as the presence of comorbid conditions like depression and anxiety. Accurate and real-time prediction of suicidal thoughts may lead to improved management of patients with depression. Prediction of suicidality is difficult due to its day-to-day variability in relation to mood and anxiety symptoms. This can be overcome with the advent of mobile health (mHealth) technology that can capture granular data scores at a higher frequency than conventional therapeutic visitations. Objective The aim of this study is to predict suicidal ideation using self-reported mood and anxiety in patients undergoing treatment for depression. Methods This study will use data from the DepWatch study, an mHealth study that uses the DepWatch app developed by our research group. The objective of this longitudinal study is to develop an mHealth-based, personalized diagnostic prediction system for patients undergoing treatment for depression. Patients are followed over 12 weeks using electronic assessments conducted via the DepWatch app installed on their smartphones. The electronic assessments include the Quick Inventory of Depression Symptomatology-Self Report (QIDS-SR), conducted on a weekly basis, and weekly medication adherence and medication safety and tolerability questionnaires. The assessments include brief mood and anxiety assessments conducted on a daily basis. Generalized estimating equation modeling for a binary outcome (the presence or absence of suicidal thought), clustered by individual subjects, will be used. The key explanatory variables are the daily mood and anxiety levels (time variant). The outcome variable is suicidal ideation as determined by the self-reported subject response to question 12 (about suicidality) on the QIDS-SR scale. Variables that show significance at P values <.1 are subsequently used in the multivariate model, in addition to mood and anxiety. Results A total of 34 subjects are in the interim analysis set. The median age is 26 years, 85.3% are female, and 64.7% are White. In addition, 38.2% either have a college degree or graduate education, while 23.5% are unemployed and 41.1% are full-time employed. About half of participants (52.9%) earn less than $50,000 annually and 61% have never smoked. Univariate analysis shows statistical significance of gender, race, aggregate anxiety, and employment status at .1 significance level. In the multivariate model, only gender and employment status are significant at .05. Race is marginally insignificant (P=.068). Conclusions Suicidality and completed suicides are significant public health problems, especially in patients with depression. The mHealth technology and statistical modelling that captures daily variability in anxiety leading up to suicidal ideation can help predict suicidality. Conflicts of Interest None declared.

Sleep influences daily suicidal ideation through affective reactivity to interpersonal events among high-risk adolescents and young adults.

Identifying proximal risk factors for suicidal ideation that are modifiable and relevant for adolescents and young adults is critical for suicide prevention. This study used an intensive monitoring approach to examine whether objectively- and subjectively- measured sleep characteristics predict next-day suicidal ideation occurrence and intensity through affective reactivity to interpersonal events in young people at high risk for suicide. Participants included 59 (13-23 years; 76% White; 75% female) adolescents and young adults undergoing intensive outpatient program treatment for depression and suicidality. Participants completed daily ratings of suicidal ideation, sleep quality, and affective reactivity to positive and negative interpersonal events for up to 3 months (M = 56 days, SD = 24.13). Actigraphy captured behavioral sleep duration and timing. Multilevel modeling was used to evaluate within-person fluctuations in sleep and affective reactivity as predictors of suicidal ideation, and multilevel mediation tested the indirect effects of sleep on suicidal ideation via affective reactivity to interpersonal events. Results indicate significant indirect effects of objectively measured sleep duration and subjective sleep quality on next-day suicidal ideation via affective reactivity to negative and positive interpersonal events, respectively. Shorter-than-usual sleep predicted the presence and intensity of next-day suicidal ideation via heightened affective reactivity to negative interpersonal events. Worse sleep quality than usual predicted next-day suicidal ideation via reduced affective reactivity to positive interpersonal events. Affectivity reactivity is a proximal mechanism through which sleep indices may influence risk for suicidal thinking on a daily basis. Findings highlight the utility of targeting sleep and emotion regulation in suicide prevention among adolescents and young adults at high-risk for suicide.

The Effects of Emotional Dysregulation and Impulsivity on Suicidality in Patients with Bipolar Disorder

Introduction Bipolar disorder (BD) is a prevalent, often severe, and disabling illness that affects about 1-5% of the general population and has the highest risk of suicide among psychiatric disorders. Impulsivity and, emotion dysregulation have been emphasized due to their role in facilitating suicide acts among those with suicide ideation.Objectives This study aimed to examine the relationship between emotional dysregulation, impulsivity, and suicidality in patients with bipolar disorder by comparing bipolar patients with healthy individualsMethodsThe study included 85 patients (59 women, 26 men) with bipolar disorder and education and age-matched 65 (44 women, 21 men) healthy volunteers. The patient group was divided into 3 subgroups according to have suicide attempt history, have suicide ideation without attempt, and have neither suicide attempt nor ideation. Sociodemographic Form, The Difficulties in Emotion Regulation Scale (DERS), Barratt Impulsivity Scale (BIS-11), Scale for Suicide Ideation, Suicide Behaviors Questionnaire scales were applied to the participants.ResultsPatients with bipolar disorder had significantly higher scores for emotion dysregulation and impulsivity than the healthy control group. A statistically significant correlation was found between emotion dysregulation, impulsivity, suicide ideation, and suicide behavior scores. DERS Total and Barratt Total scores were found higher for bipolar patients with suicide attempts than bipolar patients with suicide ideation and bipolar patients with neither attempt nor ideation. The hierarchical regression analysis has indicated that strategies, clarity, and non-planing impulsiveness were the predictors of suicide ideation in bipolar patients.ConclusionsThe results suggested a strong association between emotional dysregulation, impulsivity with suicide ideation, and behavior in patients with bipolar disorder.DisclosureNo significant relationships.

Changes in suicidal ideation and related influential factors in college students during the COVID-19 lockdown in China

This study aims to investigate the patterns and predictors of suicidal ideation (SI) trajectories among college students during extended lockdowns in China. A three-wave survey was conducted during the outbreak period, remission period, and prevention period of COVID-19. Distinct patterns of SI trajectories were established by grouping respondents based on temporal changes in SI. Multivariate logistic regressions were performed to examine predictors for delay-occurrence and persistent SI. From a total of 35,516 college students included in the study, rates of SI increased significantly from T1 to T2 (7.3% v. 9.4%) and from T2 to T3 (9.4% v. 12.6%). Five SI trajectories were observed: resilient (80.5% of the sample), recovery (3.6%), relapsing/remitting (4.8%), persistent dysfunction (2.3%) and delayed dysfunction (8.7%). Further, junior-year undergraduates, postgraduates, only-child families, mental health history, confirmed cases in the community of residence, depressive symptoms, and negative coping strategies were significant predictors of distinct SI trajectories, whereas greater social support, more positive coping strategies, and better family functioning were associated with a lower probability of developing delayed or persistent dysfunction during the lockdown period. These findings suggest that continuous preventive and intervening measures for college students during COVID-19 lockdowns are of global importance, particularly among vulnerable groups who experience the most distress.

Risk factor analysis and nomogram construction for predicting suicidal ideation in patients with cancer

BackgroundSuicidal ideation in cancer patients is a critical challenge. At present, few studies focus on factors associated with suicidal ideation, and predictive models are still lacking. This study aimed at investigating the risk factors for suicidal ideation among cancer patients, and developed a predictive nomogram to screen high risk cancer patients for early prevention and intervention.MethodsA questionnaire survey was conducted among cancer patients between May 2021 and January 2022. The factors associated with suicidal ideation were used to construct a multivariate logistic regression model, which was visualized as a predictive nomogram to evaluate the risk of suicidal ideation. Areas under the curve, calibration plot, decision curve analysis, and internal and external validation were used to validate the discrimination, calibration and clinical usefulness of the model.ResultsA total of 820 patients with cancer were recruited for this study and 213 (25.98%) developed suicidal ideation. Levels of demoralization, depression and cancer staging, marital status, residence, medical financial burden, and living condition were influence factors for suicidal ideation. Comparing nomogram with Self-rating Idea of Suicide Scale (SIOSS), the nomogram had a satisfactory discrimination ability with an AUC of 0.859 (95% CI: 0.827–0.890) and 0.818 (95% CI: 0.764–0.873) in the training and validation sets, respectively. The calibration plot and decision curve analysis revealed that this nomogram was in good fitness and could be beneficial in clinical applications.ConclusionsSuicidal ideation is common in cancer patients. Levels of demoralization, depression and cancer staging were independent predictors of suicidal ideation. The nomogram is an effective and simple tool for predictive suicidal ideation in cancer patients.

Prevalence and Predictors of Suicidal Ideation in Patients Following Cardiac Surgery.

Patient-reported outcomes (PROs) which demand special attention and immediate help are referred to as PROs alert. Suicidal ideation (SI) is one of the PROs alerts which are insufficiently investigated. The aim was to assess the prevalence and risk factors for SI in patients following cardiac surgery. A total of 190 patients (mean age: 66.09, SD = 10.19; 57 women) were assessed at three months following cardiac surgery. SI was identified using the Patient Health Qustionnaire-9 (PHQ-9) question. The Hospital Anxiety and Depression Scale-Modified was used to assess anxiety, depression, and irritability. Additionally, self-perceived health improvement and level of hope were assessed using the Likert scale. Dyspnea and chest pain were assessed using a visual analogue scale. SI was observed in 14.7% of participants. Patients experiencing SI had significantly higher levels of depression, anxiety, irritability, dyspnea and chest pain. They perceived the surgery to be less effective and had lower levels of hope. No significant relationships were found regarding age, sex, employment status, myocardial infarction, heart failure, operation mode, type of procedure, extracorporal circulation, hospital stay and postsurgical complications. Logistic regression revealed female sex (B = 2.363), higher anxiety level (B = 0.451) and older age (B = 0.062) to be risk factors for SI. The total variance explained by the model was 46%. Assessing suicidality and negative emotions with special emphasis on anxiety simultaneously with somatic complaints is vital to address PROs alerts and improve care for patients following cardiac surgery. In-depth evaluation and psychological care are recommended in case of positive screening.

Study Protocol for an Ecological Momentary Assessment Study: TempRes "Temporal Variability of Risk and Resilience Factors for Suicidal Ideation".

Suicide prevention is an important public mental health issue that can be significantly brought forward by recent advances in psychological research methods and assessment. The project “TempRes” aims to harness the power of Ecological Momentary Assessment (EMA) to investigate the transdiagnostic risk and resilience factors associated with suicidal ideation drawn from the most recent research in suicide prevention and personality assessment. Participants will comprise the general population (planned: N = 100) and a risk group (patients currently in psychosomatic or psychiatric treatment) (planned: N = 50). After a comprehensive baseline assessment, they will complete up to ten short assessments per day over the course of 10 days at roughly equidistant intervals. In detail, the project examines the interplay of biography (previous suicidal behavior, experiences of childhood maltreatment), individual differences (level of personality functioning), and time-varying factors (entrapment, loneliness, mood) with respect to the emergence and fluctuation of suicidal ideation. There are two main research foci: First, the project will provide an operationalization and empirical verification of a core assumption of the integrated motivational-volitional model of suicide (IMV model). It will test whether the interaction of the time-varying predictors entrapment with loneliness (as a motivational moderator) explains reports of suicidal ideation over time. Second, it will be the first to examine personality functioning (a transdiagnostic, psychodynamically grounded conceptualization of vulnerability to psychological crises over the life span) as a time-invariant predictor of suicidal ideation assessed within an intensive longitudinal study design. The main analyses will be built on linear mixed models. The overarching aim of the project is to gain a better understanding of the psychological dynamics underlying suicidal ideation in different populations by bringing together concepts from different theoretical traditions. This will inform prevention efforts geared toward the general public as well as intervention in clinical populations.

Prediction of suicidal ideation in shift workers compared to non-shift workers using machine learning techniques

BackgroundShift work can affect sleep and increase the risk of suicide. This study attempted to predict suicidal ideation according to shift work by using machine learning techniques. MethodsWe analyzed a total of 43,095 data conducted by using the 10-year Korean National Health and Nutrition Examination Survey (KHANES). Shift workers and daytime workers were categorized and analyzed using random forest (RF) and decision tree (DT) techniques of machine learning techniques. ResultsShift workers were more than twice as likely to have suicidal ideation as daytime workers. The RF model showed an accuracy of 91.6% for shift workers and 98% for daytime workers. In the DT technique, the rate of suicidal ideation was the highest among shift workers (82.7%) when they were depressed and had an EuroQol-5 Dimension (EQ-5D) score of less than 0.71. LimitationsShift work type was evaluated questionnaire and based on screening data, it was not possible to reflect recent changes in the work type and we evaluated for only suicidal ideation for suicide risk factors. ConclusionThe variables influencing the suicide risk of shift workers and daytime workers differ. In the case of shift workers, negative factors such as depression and low quality of life are risk factors for suicide. Efforts are needed to reduce risk factors through administrative and policy interventions to manage workers' health by early screening.

The Effectiveness of Predicting Suicidal Ideation through Depressive Symptoms and Social Isolation Using Machine Learning Techniques

(1) Background: Social isolation is a major risk factor for suicidal ideation. In this study, we investigated whether the evaluation of both depression and social isolation in combination could effectively predict suicidal ideation; (2) Methods: A total of 7994 data collected from community residents were analyzed. Statistical analysis was performed using age, the Patient Health Questionnaire-9, and the Lubben Social Network Scale as predictors as the dependent variables for suicidal ideation; machine learning (ML) methods K-Nearest Neighbors, Random Forest, and Neural Network Classification were used; (3) Results: The prediction of suicidal ideation using depression and social isolation showed high area under the curve (0.643–0.836) and specificity (0.959–0.987) in all ML techniques. In the predictor model (model 2) that additionally evaluated social isolation, the validation accuracy consistently increased compared to the depression-only model (model 1); (4) Conclusions: It is confirmed that the machine learning technique using depression and social isolation can be an effective method when predicting suicidal ideation.

The Moderating Role of Working Alliance in the Association Between Depression and Suicide Ideation in Messaging Therapy.

Introduction: Suicide is one of the leading causes of death worldwide, and it can be prevented by psychotherapy. The objective of this study was to examine the risk factors predicting suicide ideation during messaging psychotherapy, and the moderating role of working alliance (WA) in the association between baseline depression and later suicide ideation. Materials and Methods: A large outpatient sample (n = 4,388) engaged in daily messaging with licensed clinicians from a telemedicine provider. Using a longitudinal design, depression and anxiety symptoms were assessed at baseline, using the Patient Health Questionnaire (PHQ-8) for depression and the Generalized Anxiety Disorder (GAD-7) for anxiety. The WA was measured with the short version of the Working Alliance Inventory after 3 weeks of therapy, and suicide ideation was assessed at baseline and after 6 weeks of therapy, by item 9 of the Patient Health Questionnaire (PHQ-9). Demographic measures were also assessed. Results: Results indicate that depression (β = 0.09, p < 0.001), baseline suicide ideation (β = 0.50, p < 0.001), and WA (β = -0.08, p < 0.001), especially the task subscale (β = -0.14, p < 0.001), significantly predicted suicide ideation after 6 weeks. WA (β = -0.07, p < 0.001), especially the task (β = -0.14, p < 0.001) and bond subscales (β = 0.06, p = 0.002), moderated the association between depression at baseline and suicide ideation after 6 weeks, so that experiencing higher quality of WA decreased the association between depression and suicide ideation. Discussion and Conclusions: Suicide ideation may be reduced by experiencing the therapeutic relationship as beneficial, even among at-risk populations, which suffer from depressive symptoms. It is the first study to show this moderation effect in any platform of therapy.

Interpersonal Predictors of Suicide Ideation and Attempt among Middle Adolescents

Interpersonal Predictors of Suicide Ideation and Attempt among Middle Adolescents

Predictors of Suicide Ideation and Attempt Planning in a Large Sample of New Zealand Help-Seekers.

AimSuicide is a major public health concern worldwide. The present study explores the risk factors for suicide ideation and suicide attempt planning by analyzing anonymized data collected by a New Zealand telephone helpline.MethodA nation-wide helpline, Lifeline Aoteroa, provided data from distressed callers obtained from May 2017 to April 2018. The analyzed sample consisted of 32,889 counseling calls of clients with a wide range of presenting issues. Frequency analysis and multivariable logistic regression were adopted to determine risk and protective factors associated with two types of suicide behaviors: suicide ideation and suicide planning.ResultsRisk factors for suicide ideation and suicide planning included: hopelessness, sadness, fear, not coping with symptoms of mental health issues, mild/moderate severity self-harm, severe self-harm, urge to self-harm, alcohol and/or drug addiction, suicide in family, sexual domestic abuse. The adjusted odds rations for these risk factors ranging from 1.31 to 16.42. Protective factors included feelings of hope or joy, the opportunity to talk and, unexpectedly, feeling anxious or stuck. The adjusted odds ratios for protective factors ranged from 0.15 to 0.75.ConclusionRisk factors were identified for both suicide ideation and for suicide attempt planning. While some of these risk factors have been reported in existing literature, there are also risk factors unique to the present study that could inform and improve suicide-screening procedures administered by clinicians or helplines.

Suicide risk and ideation among patients with substance use disorders in Egypt

ABSTRACT Background Patients with substance use disorders are at high risk for suicidal ideas and behaviors. Prevention of suicide among these patients should be a public health priority. Objective The objective of this study was to investigate the prevalence and correlates of suicidal ideas and suicide risk among patients with substance use disorders. Methods This study included 100 patients with substance use disorders who sought treatment at Zagazig University hospital, Egypt. All participants were interviewed using Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition-Text-Revised and rated by Beck Suicide Scale. Drug-related problems were assessed using the Arabic version of Addiction Severity Index. Urine screen for drugs was done for all patients participated in the study. Results Twenty-seven percent of the patients with substance use disorders had suicidal ideas, 22% had suicide risk, and 9% had history of suicidal attempts. Females were 5 times more likely to have suicide risk than males. Unemployed patients were three times more likely to have suicide risk than employed or skilled workers. There was an association between suicide risk and heroin use and alcohol dependence and patients with positive family history of suicide. . Conclusions Suicidal ideas and suicide risk were common among patients with substance use disorders. Female gender, unemployment, heroin use, and alcohol dependence and positive family history of suicide were predictors of suicide ideation and risk in patients with substance use disorders.

Socio-demographic, economic and mental health problems were risk factors for suicidal ideation among Kenyan students aged 15 plus

BackgroundAbout a third of youth with suicidal ideation develop suicidal plans and about 60% of youth with suicidal plans make suicidal attempts. This study aimed to study different types of suicidal ideation and the risk factors in Kenyan youth. MethodsWe studied a total of 9742 high school, college and university students using following self-administered instruments: - a researcher design socio-demographic questionnaire, Psychiatric Diagnostic Screening Questionnaire (PDSQ) to document psychiatric disorders and various types of suicidal ideas in previous two weeks, Washington Early Recognition Center Affectivity and Psychosis tool to assess stress, affectivity and psychosis, Wealth index questionnaire to document economic indicators based on household items for the families of the students. We used descriptive statistics, univariate analysis, bivariate logistic regression analysis and variables with a p-value of less than <.05 were entered into generalized linear models using logit links to identify independent predictors. ResultsThe overall prevalence of different types of suicidal ideation was (22.6%), major depression was found in 20.0%, affectivity, psychosis and stress was found in 10.4%, 8.7% and 26.0% respectively. Female gender, major depression, stress, affectivity and psychosis and being in high school were significant (p < 0.05) predictors of suicidal ideation. LimitationsThis was a cross sectional study that focused only on suicidal ideas and associated economic factors and mental health disorders. It did not study suicidal behavior. ConclusionFuture studies are needed to study the progression from suicidal ideas to suicidal attempts and the factors associated with that progression.

Can HRM predict mental health crises? Using HR analytics to unpack the link between employment and suicidal thoughts and behaviors

PurposeThe aim of this research is to determine the extent to which the human resource (HR) function can screen and potentially predict suicidal employees and offer preventative mental health assistance.Design/methodology/approachDrawing from the 2019 National Survey of Drug Use and Health (N = 56,136), this paper employs multivariate binary logistic regression to model the work-related predictors of suicidal ideation, planning and attempts.FindingsThe results indicate that known periods of joblessness, the total number of sick days and absenteeism over the last 12 months are significantly associated with various suicidal outcomes while controlling for key psychosocial correlates. The results also indicate that employee assistance programs are associated with a significantly reduced likelihood of suicidal ideation. These findings are consistent with conservation of resources theory.Research limitations/implicationsThis research demonstrates preliminarily that the HR function can unobtrusively detect employee mental health crises by collecting data on key predictors.Originality/valueIn the era of COVID-19, employers have a duty of care to safeguard employee mental health. To this end, the authors offer an innovative way through which the HR function can employ predictive analytics to address mental health crises before they result in tragedy.

Prediction of suicidal ideation risk in a prospective cohort study of medical interns.

The purpose of this study was to identify individual and residency program factors associated with increased suicide risk, as measured by suicidal ideation. We utilized a prospective, longitudinal cohort study design to assess the prevalence and predictors of suicidal ideation in 6,691 (2012-2014 cohorts, training data set) and 4,904 (2015 cohort, test data set) first-year training physicians (interns) at hospital systems across the United States. We assessed suicidal ideation two months before internship and then quarterly through intern year. The prevalence of reported suicidal ideation in the study population increased from 3.0% at baseline to a mean of 6.9% during internship. 16.4% of interns reported suicidal ideation at least once during their internship. In the training dataset, a series of baseline demographic (male gender) and psychological factors (high neuroticism, depressive symptoms and suicidal ideation) were associated with increased risk of suicidal ideation during internship. Further, prior quarter psychiatric symptoms (depressive symptoms and suicidal ideation) and concurrent work-related factors (increase in self-reported work hours and medical errors) were associated with increased risk of suicidal ideation. A model derived from the training dataset had a predicted area under the Receiver Operating Characteristic curve (AUC) of 0.83 in the test dataset. The suicidal ideation risk predictors analyzed in this study can help programs and interns identify those at risk for suicidal ideation before the onset of training. Further, increases in self-reported work hours and environments associated with increased medical errors are potentially modifiable factors for residency programs to target to reduce suicide risk.

Predictors of suicidal ideation in social anxiety disorder – evidence for the validity of the Interpersonal Theory of Suicide

BackgroundThis study aims to identify covariates of suicidal ideation (SI) in a large sample of individuals diagnosed with social anxiety disorder (SAD). MethodsIn a cross-sectional design, 305 individuals (38.4 ± 14.1 years, 59% female) with SAD were assessed by the Social Phobia Inventory, Beck Depression Inventory, Adverse Childhood Experience Questionnaire, State Trait Anger Expression Inventory, Beck Scale for Suicidal Ideation and the Interpersonal Needs Questionnaire. ResultsSAD individuals with SI (n = 142, 46.6%) reported higher SAD and depression symptoms, more adverse childhood experiences (ACE), higher state anger (SA), perceived burdensomeness (PB) and higher thwarted belongingness (TB) compared to SAD individuals without SI (n = 163, 53.4%). In binary logistic regression, PB (odds ratio (OR) = 1.11, 95% confidence interval (CI) = 1.06–1.15), TB (OR = 1.05, 95% CI = 1.02–1.07), SA (OR = 1.07, 95% CI = 1.01–1.13) and ACE (OR = 1.18, 95% CI = 1.03–1.35) emerged as significant covariates of acute SI (Nagelkerke's R2 = 0.39). Receiver operating characteristic (ROC) curves showcased the following areas under the curve (AUC): PB (AUC = 0.78), TB (AUC = 0.76), SA (AUC = 0.62) and ACE (AUC = 0.62). Multinomial logistic regression (no SI = ref.) showcased similar results for passive and active SI (n = 42), with SA reaching significance only for active SI. The Youden index identified appropriate cut-off values for PB, TB, SA and ACEQ by maximizing sensitivity and specificity. LimitationsCross-sectional design and self-reporting measures limit generalization. ConclusionOur findings confirm the validity of the Interpersonal Theory of Suicide concerning SI in SAD. PB and TB with SA and ACE may support the valid assessment of SI in therapeutic settings.