Predictors Of Suicidal Ideation Research Articles

Suicidal ideations: The role of emotional intelligence and hopelessness among police in Malaysia

Suicide has become an alarming phenomenon among the Royal Malaysia Police (RMP) with reported cases showing an increase each year. This cross-sectional study examines the association between depression, emotional intelligence (EI), hopelessness, and the prediction of suicidal ideation among police officers in Malaysia. A total of 2,508 police officers in 15 police contingents and the Royal Malaysia Police Head Quarters completed the questionnaires. The Beck Depression Inventory (BDI) was used to measure depression, and the Wong and Law Emotional Intelligence Scale (WLEIS) was employed to calculate overall emotional intelligence. The hopelessness variable was measured via the Beck Hopelessness Scale (BHS). The Revised Suicide Ideation Scale (R-SIS) was used to measure the tendency and severity of suicidal intention. The data were analysed using Statistical Package for the Social Sciences (SPSS) version 29.0. The study found that emotional intelligence showed a significant negative correlation with suicidal ideation. Depression and hopelessness were significantly positively correlated with suicidal ideation. Further analysis using the logistic regression approach (stepwise) revealed that both depression, and hopelessness, were risk factors that influenced suicidal ideation among the police. Mediation analyses show that emotional intelligence and hopelessness act as mediators in the relationship between depression and suicidal ideation. Therefore, mental health professionals can design appropriate prevention and intervention programmes for those with suicidal ideation.

Prevalence of suicide ideation and its associated risk factors among undergraduate students of the university for development studies, Tamale

BackgroundSuicide and its associated risk factors are of public health importance across the globe. The affected persons are mostly the youth. Empirical research in this crucial area of public health is generally lacking, especially among undergraduate university students in Ghana. This study sought to determine the prevalence of suicide ideation, and its associated risk factors that statistically predict suicide ideation among undergraduate students. Methods: A descriptive cross-sectional quantitative survey was conducted. A structured online questionnaire was used to elicit information on the prevalence of suicide ideation and its correlates. A systematic sampling technique was used to sample 400 respondents. Of this number, 53.25% were male and 46.75% were female. Data were analyzed using SPSS v26. Results were presented in charts, tables, and cross-tabulations. A regression analysis was also done to model suicide ideation with socio-demographic variables. Results: The prevalence of suicide ideation among participants was 24.5%. Significant risk factors for suicide ideation found in the study were academic stress and victimization. Suicide ideation was predicted with statistical significance by the presence of victimization (OR = 3), and academic stress (OR = 2). Conclusion: The prevalence of suicide ideation among participants is real and will need combined efforts of university management and, the counseling unit to put in place interventions that will help avert suicide ideation and its dreaded squeal of completed suicide.

Trajectories and predictors of suicidal ideation in clinical characteristics and pharmacological treatments for major depressive disorder: a study based on a national multi-centered prospective cohort

Suicidal ideation (SI) is a significant precursor and risk marker for suicide behaviors in major depressive disorder (MDD). Exploration of SI trajectory from a longitudinal framework are essential for treatment guidelines and clinical management of suicide risk. This study sought to explore SI trajectories and its associated clinical, sociodemographic characteristics, and initial treatment among patients with MDD. We used data from a non-interventional, national multi-centered prospective cohort study. 1 461 patients with MDD were included in the growth mixture modeling using SI at baseline, 2 weeks, 4 weeks, 8 weeks, 12 weeks, and 6 months, 9 months, and 12 months as the indicator. A multinomial regression was employed with SI trajectory as the outcome and anhedonia, depressive symptoms, atypical depressive symptoms, pharmacological treatments, and other covariates as the predictors. Four distinct SI trajectories were identified: a consistently low SI trajectory(50.7%), a persistently mild SI trajectory(20.6%), a fast declined SI trajectory(8.9%), and a slowly declined trajectory(19.8%). Compared to those with a consistently low SI trajectory, a higher score of anhedonia was associated with an increased risk of experiencing persistently mild (RRR = 1.20, 95%CI: 1.05, 1.38) and slowly declined SI (1.54, 95%CI: 1.32, 1.80). Severity of depressive symptom was also positively associated with the risk of experiencing persistently mild (1.15, 95%CI: 1.13, 1.18) and slowly declined SI (1.17, 95%CI: 1.14, 1.21). And the risk of experiencing slowly declined SI was higher for those use SSRI(1.49, 95%CI: 1.02, 2.31), and for those use antidepressant and antipsychotic/mood stabilizer combined therapy (3.78, 95%CI: 1.48, 9.61). The findings of this study are potentially useful for clinical practice as critical indicators of profiles and interventions for prognosis among patients with MDD. Further research is warranted to explore potential modifiable factors and the association between SI trajectories and suicide behavior.

The relationship between existential isolation and suicidal ideation among formerly incarcerated individuals

Background and purpose Formerly incarcerated people die by suicide at a rate 6.75 times higher than the general population. In this study we ask whether existential isolation, the feeling of being alone in one’s subjective experiences, offers new insights into this staggering statistic. We specifically ask whether existential isolation predicts suicidal ideation among formerly incarcerated individuals even after accounting for their levels of interpersonal isolation, emotional support, and instrumental support. Method We examined cross-sectional survey data from American participants (n = 946) recruited over the Amazon Mechanical Turk (MTurk) platform. Results Consistent with prediction, we found that people with an incarceration history reported more existential isolation, but not more interpersonal isolation, than those without an incarceration history. A hierarchical regression analysis revealed that existential isolation explained additional variance in suicidal ideation beyond what was explained by interpersonal isolation, instrumental support, and emotional support. Fisher’s r-to-z transformations demonstrated that the magnitude of the relationship between existential isolation and suicidal ideation was stronger among those with an incarceration history than among those without. Finally, existential isolation mediated the relationship between incarceration and suicidal thoughts, even when holding constant other predictors of suicidal ideation. Conclusion Reentry programs may target existential isolation among formerly incarcerated individuals to improve emotional wellbeing.

Suicidality Trajectory, Hopelessness, Resilience, and Self-Efficacy Among Patients With Treatment-Resistant Depression in Vietnam.

Patients with treatment-resistant depression (TRD) have higher rates of suicidal ideation and a higher suicide attempt prevalence than patients with other types of depression. This study was designed to study the suicidality trajectory and relationships between hopelessness, resilient coping, and self-efficacy, respectively, and suicidal ideation and suicide attempts in patients with TRD during hospitalization and at 3 months after discharge. A longitudinal survey of 53 psychiatric inpatients with TRD was conducted. Suicidality, hopelessness, resilient coping, self-reported medication adherence, and self-efficacy were assessed at Weeks 1 and 2 (T0 and T1) after hospitalization and Week 1 and Months 1 and 3 after discharge. Data were analyzed using a Cox regression model. Suicidality varied across the five time points, with a downward trend observed between T0 and T1 (reflecting the initial effects of inpatient treatment) and an upward trend observed across the 3-month follow-up. Antidepressant overdose was the most common method used for suicide. The risk of high suicidal ideation during follow-up was 1.63, 2.63, and 1.14 times higher, respectively, in participants with a high level of hopelessness, low level of resilient coping, and low self-efficacy. Also, having a higher level of hopelessness and being younger in age increased the risk of attempting suicide by 3.07 times and over 6 times, respectively, compared to older participants. Suicidality was shown to fluctuate between the in-hospital treatment phase and the first 3 months following discharge in this sample of patients with TRD. Younger age, feelings of hopelessness, low resilience, and low self-efficacy were the top four factors contributing to postdischarge suicide risk. These findings highlight the need for regular patient monitoring and assessment to identify those with TRD who are at high risk of suicide as well as the importance of focusing on hopelessness, resilience, and self-efficacy as predictors of suicide ideation and attempts. Nurses should help patients with TRD, especially those who are younger, and improve and maintain their hope, resilience, and self-efficacy both during hospitalization and shortly after discharge.

An exploratory analysis on the association between suicidal ideation and the microbiome in patients with or without major depressive disorder

BackgroundScarce research has investigated associations between suicidal ideation and the gut microbiota. We aimed to explore variations in the gut microbiome associated with suicidal ideation and major depressive disorder (MDD). MethodA case-control study compared abundances of fecal microbiota and biomarkers of gut permeability among patients with MDD, with or without suicidal ideation, and healthy volunteers without depression. Information on demographic variables and assessments of suicidal ideation (Beck Suicidal Ideation Scale), depression (Hamilton Depression Scale, Patient Health Questionnaire, Hospital Anxiety and Depression Scale- Depression), as well as anxiety (Hospital Anxiety and Depression Scale- Anxiety), were obtained. Univariate and multivariate regression model was performed to explore the possible predictors of suicidal ideation. ResultsAmong the 140 participants, significant differences in Beta diversity were found between MDD patients with (n = 43) or without suicidal ideation (n = 34), and healthy volunteers (n = 42) (all p < 0.001). The strain of g-Phascolarctobacterium was found to have significant positive associations with scores of BSSI and BSSI Part 1 (suicidal ideation), particularly in MDD patients with suicidal ideation, after controlling for demographic and mood covariates. Mediation analyses revealed that g-Phascolarctobacterium may be a partial mediator between depression and suicidal ideation; however, it is also possible that the association between g-Phascolarctobacterium and suicidal ideation was partially mediated by the level of depression. ConclusionWe found different compositions, diversities, and possible mediating of the gut microbiome associated with suicidal ideations. Potential mechanisms need further investigation to establish whether this reflects a biological process that might be the focus for intervention development. SynopsisOur objective was to investigate whether the diversities and abundances of the gut microbiome varied in people with or without suicidal ideation and with or without MDD after considering possible demographic and mood confounders.

Predictors of suicidal ideation in Italian veterinarians

Suicide represents a significant problem for healthcare professionals such as veterinarians. Previous studies showed that contextual and individual risk factors can contribute to suicidality among veterinarians. In the present study, self-report measures on exposure to animal euthanasia, substance abuse, reflective functioning, and suicidal ideation were administered to 1556 Italian veterinarians aged 24–74 years old. Structural equation modelling revealed that failures in reflective functioning and substance abuse were associated with suicidal ideation. Prevention programs focusing on improving reflective functioning and decreasing substance abuse might reduce suicide risk among veterinarians.

SUICIDE IDEATION: AGE AND CORRELATES AMONG UNIVERSITY STUDENTS IN NYANZA REGION, KENYA

Suicidal behaviors have been on the rise among university students in the recent past. The aim of this paper was to examine suicide ideation in relation to age category and correlates among university students in the Nyanza region with the aim of preventing occurrences of completed suicide. The objectives of the study were to determine the difference in age category in relation to suicide ideation and to examine the correlates of suicide ideation. The study was based on the Three Step Theory of Suicide (3ST) by Klonsky, May and Saffer. The research design employed was a correlational research design. Purposive sampling was used to select four public universities from the Nyanza region as well as university counsellors. Stratified sampling was thereafter used to select undergraduate students depending on their year of study. Simple random sampling was finally used to select 1477 students from the four universities with the guidance of a sample size table developed by Krejcie and Morgan (1970). Student questionnaires, interview schedules as well as counseling records were used to collect data. Data analysis was done using Statistical Package for Social Sciences (SPSS V20). Descriptive statistics, including frequencies and percentages, were used. Quantitative data was thereafter analyzed using chi-square and linear regression at a .05 level of significance, and qualitative data was analyzed using themes. The study findings revealed that suicide ideation was not related to the age category of the students. The results from linear regression analysis indicated that sexual abuse, romantic break up, alcohol addiction, HIV/AIDS, elections and cyber suicide are predictors of suicide ideation, while financial crisis and COVID-19 are not predictors of suicide ideation. The study recommends that the ratio of student to counsellor at the university should be increased to allow for easy access to counselling services. The study also recommends that during orientation, the counselling department should create awareness of some of the stressful life events students are likely to encounter on campus and equip them with coping skills, as well as encourage them to visit the counselling department whenever they feel like talking to someone.&lt;p&gt; &lt;/p&gt;&lt;p&gt;&lt;strong&gt; Article visualizations:&lt;/strong&gt;&lt;/p&gt;&lt;p&gt;&lt;img src="/-counters-/soc/0784/a.php" alt="Hit counter" /&gt;&lt;/p&gt;

Resilience and social support as protective factors against suicidal ideation among tertiary students during COVID-19: a cross-sectional study

BackgroundSuicidal ideation is a depression symptom which represents a key (cognitive) component of suicidality and plays an important role in suicide risk detection, intervention, and prevention. Despite existing research showing the importance of certain factors of depression symptoms and suicidal ideation, less is known about the interaction between the various risk and protective factors. The aim of the study was to examine whether living conditions characteristics and personal circumstances during the COVID-19 pandemic predicted the presence of depression symptoms and suicidal ideation among tertiary students and whether resilience and social support can mitigate the detrimental effects of difficult life circumstances.MethodA large online cross-sectional study was conducted in March 2021 among 4,645 Slovenian tertiary students. Hierarchical multiple regression and hierarchical logistic regression methods were used to assess and compare the effect of life circumstances variables, as opposed to resilience and social support, on depression symptoms and suicidal ideation.ResultsFemale gender, single relationship status, living alone, a higher degree of household conflict, having a history of mental illness and chronic disease diagnosis were significant predictors of depression scores. All but gender were also predictors of suicidal ideation. Household conflict and a history of mental illness were the factors showing the strongest effect in both cases. On the other hand, social support and, in particular, resilience proved to be strong protective factors against depression symptoms and suicidal ideation. After accounting for one’s resilience and social support, the explained variance in depression scores was more than doubled, while the harmful effect of household conflict and history of mental illness significantly decreased.ConclusionsThe findings stress the importance of one’s resilience and social support and explain why some people manage to maintain mental well-being despite finding themselves in difficult life circumstances, which was the case for many tertiary students during the COVID-19 pandemic. These insights may inform preventive efforts against developing suicidal ideation and may be used as support for the design and implementation of interventions for improving resilience and social support from childhood onward.

Prevalence and Predictors of Suicidal Ideation among Adolescents

Suicides among young people continue to be a serious problem. Suicide is the second leading cause of death for children, adolescents, and young adults. The objectives of the present study were to assess the prevalence and predictors of suicidal ideation among adolescents; associate suicidal ideation among adolescents with selected socio-demographic variables and predictors. Quantitative research approach and descriptive research design was adopted for the study. The study was conducted among 250 adolescents selected through purposive sampling technique from selected Colleges, Thrissur. The tool consisted of a semi structured questionnaire to assess the socio-demographic data, Columbia Suicidal Severity Rating Scale (C-SSRS) screen version to assess the prevalence of suicidal ideation and a structured questionnaire to assess the predictors of suicidal ideation among adolescents. Reliability and validity of the tools were established. Data were collected, tabulated and analyzed using descriptive and inferential statistics. The findings of the study revealed that the prevalence rate of suicidal ideation among adolescents is 28%. The predictors such as lack of teachers support (91.4%), social media abuse (74.3%), loneliness and hopeless (72.9%) are found in most of the adolescents. A statistically significant association was found between education of father (p=0.04) and education of mother (p=0.04) with suicidal ideation among adolescents at p&lt;0.05. The predictors such as family history of suicide (p=0.00), helplessness (p=0.04) and lack of parental support (p=0.01) have a statistically significant association with suicidal ideation among adolescents. The study concluded that the prevalence rate of suicidal ideation among adolescents is significant. The early identification of the predictors can prevent the actual occurrence of suicide among adolescents.

Predicting Suicidal Ideation, Planning, and Attempts among the Adolescent Population of the United States.

Suicide is the second leading cause of death among individuals aged 5 to 24 in the United States (US). However, the precursors to suicide often do not surface, making suicide prevention challenging. This study aims to develop a machine learning model for predicting suicide ideation (SI), suicide planning (SP), and suicide attempts (SA) among adolescents in the US during the coronavirus pandemic. We used the 2021 Adolescent Behaviors and Experiences Survey Data. Class imbalance was addressed using the proposed data augmentation method tailored for binary variables, Modified Synthetic Minority Over-Sampling Technique. Five different ML models were trained and compared. SHapley Additive exPlanations analysis was conducted for explainability. The Logistic Regression model, identified as the most effective, showed superior performance across all targets, achieving high scores in recall: 0.82, accuracy: 0.80, and area under the Receiver Operating Characteristic curve: 0.88. Variables such as sad feelings, hopelessness, sexual behavior, and being overweight were noted as the most important predictors. Our model holds promise in helping health policymakers design effective public health interventions. By identifying vulnerable sub-groups within regions, our model can guide the implementation of tailored interventions that facilitate early identification and referral to medical treatment.

Perfectionism, Feelings of Not Mattering, and Suicide Ideation: An Integrated Test of the Perfectionism Social Disconnection Model and the Existential Model of Perfectionism

The Perfectionism Social Disconnection Model (PSDM) and the Existential Model of Perfectionism and Depressive Symptoms (EMPDS) are promising models of perfectionism and psychopathology. However, research examining suicide ideation within the PSDM is scarce, and no research has examined suicide ideation as an outcome in the EMPDS. Moreover, tests of the PSDM and EMPDS have been conducted separately and most research has examined the PSDM and EMPDS using cross-sectional or two-wave longitudinal designs, which do not provide a satisfactory test of mediation. In the current study, we addressed these limitations by testing whether perfectionism confers vulnerability to suicide ideation via feelings of mattering and anti-mattering (from the PSDM) and via difficulty accepting the past (from the EMPDS) in a three-wave longitudinal design in two independent samples of undergraduate students and community adults. Participants completed measures on three occasions over 6 weeks. Findings revealed that socially prescribed perfectionism indirectly predicted suicide ideation via difficulty accepting the past in both samples. In addition, in the undergraduate sample only, socially prescribed perfectionism indirectly predicted higher suicide ideation via anti-mattering, and self-oriented perfectionism indirectly predicted higher suicide ideation via mattering. Based on our findings, we advocate for future research to include suicide ideation in the PSDM and EMPDS, to integrate explanatory models, and to examine a mattering-specific EMPDS.

Sleep Quality and Suicidal Ideation in Adolescent Depression: A Chain Mediation Effect of Perceived Social Support and Resilience.

The prevalence of suicide is high among major depressive adolescents. Poor sleep quality has been documented as a significant risk factor for suicide, influencing perceived social support. Enhanced social support acts as a buffer against suicidal ideation and positively impacts resilience, reducing the prevalence of suicidal ideation. This reciprocal relationship between sleep quality, social support and resilience forms the basis for understanding the mechanisms contributing to suicidal ideation in major depressive adolescents. A total of 585 major depressive adolescents aged 11 to 24 years was conducted to explore these associations. Assessments included the Pittsburgh Sleep Quality Index, Multidimensional Scale of Perceived Social Support, Connor-Davidson Resilience Scale and Beck Scale for Suicide Ideation. Pearson correlation and Model 6 in the SPSS program were employed for chain mediating tests. Better sleep quality positively predicted decreased suicide ideation (β = 0.207, p < 0.01) and predicted lower perceived social support (β = -0.226, p < 0.01) and resilience (β = -0.355, p < 0.01). Perceived social support positively predicted increased resilience (β = 0.422, p < 0.01) and negatively predicted suicide ideation (β = -0.288, p < 0.01). Resilience negatively predicted suicide ideation (β = -0.187, p < 0.01). Sleep quality indirectly predicted suicide ideation through perceived social support and resilience, with a mediation value of 0.0678 (95% CI [0.0359, 0.1060]), constituting 10.65% of the total effect. This study establishes that sleep quality indirectly predicts suicide ideation in major depressive adolescents, mediated independently by perceived social support and resilience.

The effect of parent-adolescent discrepancies in reports of familial dysfunction and depression on suicidal ideation in adolescents.

Parents and adolescents are often discrepant in their reports of adolescent psychosocial factors. Few studies have addressed parent-adolescent discrepancies in subjective ratings of familial dysfunction and depression as longitudinal predictor variables, and none have done so in a treatment setting for adolescents with acute suicidality. This study examined how parent-adolescent discrepancies in familial dysfunction and depression impact adolescent treatment response in an intensive outpatient program for suicidality. Adolescents (N = 315) were assessed at treatment entry and exit for familial dysfunction, depression, and suicidal ideation. Parents received parallel assessments of familial dysfunction and adolescent depression at each time point. A polynomial regression was conducted to determine whether parent-adolescent discrepancies in reports of familial dysfunction and depression at entry related to the treatment outcome of adolescent-reported depression and suicide ideation at exit. Significant discrepancies were present with on average adolescents reporting more depression and familial dysfunction than parents. Entry discrepancy in familial dysfunction (but not depression) predicted suicide ideation at exit. Our results suggest that parent-adolescent discrepancies in perception of familial dysfunction is a risk factor for poor outcomes in suicidal youth and might be a fruitful target in treatment programs.

Prediction of suicidal ideation among preadolescent children with machine learning models: A longitudinal study

BackgroundMachine learning (ML) has been widely used to predict suicidal ideation (SI) in adolescents and adults. Nevertheless, studies of accurate and efficient models of SI prediction with preadolescent children are still needed because SI is surprisingly prevalent during the transition into adolescence. This study aimed to explore the potential of ML models to predict SI among preadolescent children. MethodsA total of 4691 Chinese children (54.89 % boys, Mage = 10.92 at baseline) and their parents completed relevant measures at baseline and the children provided 6-month follow-up data for SI. The current study compared four ML models: Random Forest (RF), Decision Tree (DT), Support Vector Machine (SVM), and Multilayer Perceptron (MLP), to predict SI and to identify variables with predictive value based on the best-performing model among Chinese preadolescent children. ResultsThe RF model achieved the highest discriminant performance with an AUC of 0.92, accuracy of 0.93 (balanced accuracy = 0.88). The factors of internalizing problems, externalizing problems, neuroticism, childhood maltreatment, and subjective well-being in school demonstrated the highest values in predicting SI. ConclusionThe findings of this study suggested that ML models based on the observation and assessment of children's general characteristics and experiences in everyday life can serve as convenient screening and evaluation tools for suicide risk assessment among Chinese preadolescent children. The findings also provide insights for early intervention.

Sleep measures as a predictor of suicidal ideation among high-risk adolescents.

Suicide is the second leading cause of death among youth aged 15-24years. Identifying modifiable risk factors relevant to adolescents is crucial for suicide prevention. Sleep patterns have been linked to suicidality in adults, but lack sufficient study in youth. This ecological momentary assessment (EMA) study aimed to explore the relationship between objectively and subjectively measured sleep characteristics and next-day suicidal ideation in high-risk youth. We included 29 adolescents (12-18 years old) admitted to the inpatient psychiatric ward post-suicide attempt or due to suicidal intent within the previous month. We conducted objective (actigraphy) and subjective (sleep diary) sleep pattern assessments over ten consecutive days. Daily suicidal ideation was evaluated using a questionnaire based on the validated C-SSRS interview. A significant positive association was observed between sleep onset latency (SOL) and expressing a "death wish" the following day (OR = 1.06, 95% CI [1-1.11], p = .04), with each minute of longer SOL increased the risk for a death wish the following day by 6%. In addition, a marginally significant negative association was observed between total sleep time (TST) and expressing a "death wish" the following day (OR = 0.57, 95% CI [0.3-1.11], p = 0.1), with each one-hour decrease in objectively measured TST increasing the odds of a death wish by 43%. Our study highlights the interplay between sleep patterns and suicidal ideation, with SOL and TST playing a significant role that may function as proximal risk factors for suicidality and as a target for intervention while treating suicidal youth.

Prediction of suicidal ideation with associated risk factors among university students in the southern part of Bangladesh: Machine learning approach

BackgroundThe prevalence of suicidal ideation has become an urgent issue, particularly among adolescents. The primary objective of this research is to determine the prevalence of suicidal ideation among students in the southern region of Bangladesh and to predict this phenomenon using machine learning (ML) models. MethodsThe data collection process involved using a simple random sampling technique to gather information from university students located in the southern region of Bangladesh during the period spreading from April 2022 to June 2022. Upon accounting for missing values and non-response rates, the ultimate sample size was determined to be 584, with 51.5 % of participants identifying as male and 48.5 % female. ResultsA significant proportion of students, precisely 19.9 %, reported experiencing suicidal ideation. Most participants were female (77 %) and unmarried (78 %). Within the machine learning (ML) framework, KNN exhibited the highest accuracy score of 91.45 %. In addition, the Random Forest (RF), and Categorical Boosting (CatBoost) algorithms exhibited comparable levels of accuracy, achieving scores of 90.60 and 90.59 respectively. LimitationsUsing a cross-sectional design in research limits the ability to establish causal relationships. ConclusionMental health practitioners can employ the KNN model alongside patients' medical histories to detect those who may be at a higher risk of attempting suicide. This approach enables healthcare professionals to take appropriate measures, such as counselling, encouraging regular sleep patterns, and addressing depression and anxiety, to prevent suicide attempts.

Predictors of Suicidal Ideation and Continued Substance Use Problems Among Patients Receiving Methadone Maintenance Treatment Who Have Co-Occurring Cocaine Use Disorder

Background Persons with polysubstance use problems are at high suicide risk, which may complicate substance use treatment. The purpose of this study was to a) examine cross-sectional and longitudinal risk factors for suicidality among persons in methadone maintenance treatment who present with co-occurring cocaine use disorder and b) evaluate whether suicidality impacts substance use outcomes independently and differentially depending on treatment type (i.e. standard methadone care [SC] vs. contingency management plus standard care [CM + SC]). Methods Data come from five randomized controlled trials of CM conducted within methadone clinics (N = 562). Participants were categorized (mutually exclusive) as no history of suicidality (56.4%, n=317), past suicidal ideation (SI; 11%, n=62), recent SI (3.6%, n=20), or lifetime suicide attempt (29%, n=163). Results Suicidality groups differed by sex and baseline employment, income, trauma history, and psychosocial functioning. Suicide attempt history was positively associated with years of polysubstance use, prior drug treatments, and unintentional overdose history. Baseline psychological problem severity and emotional abuse history were associated with SI likelihood 12 weeks later. Past SI was associated with longer durations of abstinence than no suicidality. Unexpectedly, those with recent SI reported lower drug use severity at 12 week if they received SC compared to CM + SC. Effects were small to medium. Conclusions Despite greater polysubstance use history, patients with suicide attempts did not show worse substance use outcomes than persons without suicidality. Patients with past SI fared better than those without suicidality on abstinence over 12 wk. Methadone clinics could be key points of entrance and continued services for suicide prevention.

A further comparison between meaning and purpose: Examining factor structures, partial correlational, unique, and indirect associations with mental health outcomes

ABSTRACT This study explored the factor structures, partial correlational, unique and indirect associations of meaning and purpose with depressive symptoms and suicide ideation in college students (n = 956) and adults with chronic illness (n = 346). Results showed that correlated two-factor models better captured (both absence and presence of) meaning and purpose, compared to the unidimensional models. Although meaning and purpose were strongly associated, they were differentially correlated with and predictive of mental health outcomes. On one hand, while absence of meaning was positively and moderately correlated with and predictive of depressive symptoms and suicide ideation, the associations of absence of purpose were, albeit similar, weak. On the other hand, presence of meaning was negatively and moderately correlated with and predictive of depressive symptoms and suicide ideation, and the presence of purpose only predicted suicide ideation in negligible amounts among students but not adults with chronic illness. In both samples, absence of meaning and purpose were indirectly and positively related to suicide ideation through their positive associations with depressive symptoms; whereas presence of meaning, but not presence of purpose, was indirectly and negatively associated with suicide ideation through its negative associations with depressive symptoms. Conceptual and counseling implications are discussed.

Reliability and validity of proxy reports of impulsivity and aggression: An evidence-based assessment approach to psychological autopsy methods

IntroductionPsychological autopsy methods often include measures of impulsivity and aggression. The aim is to assess their reliability and validity in a Spanish sample. MethodsCross-sectional web-based survey was fulfilled by 184 proband and proxy pairs. Data was collected on sociodemographic characteristics, impulsivity through Barratt Impulsiveness Scale (BIS-11), aggression through Buss–Perry Aggression Questionnaire (BPAQ), and history of suicide ideation. Proxies filled out BIS-11, BPAQ and suicide ideation with the responses they would expect from the probands. Reliability was assessed using intraclass correlation coefficients (ICC) between proband and proxies. Logistic regression analysis was performed to assess the predictive validity of proxy reports in predicting probands’ suicide ideation. ResultsBivariate analysis showed differences in BPAQ (Median 68 vs. 62; p=0.001), but not in BIS-11 (p>.050). BIS-11 showed good concordance (ICC=0.754; CI 95% 0.671–0.816) and BPAQ acceptable (ICC=0.592; CI 95% 0.442–0.699). In the probands regression model BPAQ predicted suicide ideation (OR 1.038; CI 95% 1.016–1.061) but not BIS-11 (OR 0.991; CI 95% 0.958–1.025). In the proxy-report model BPAQ also predicted probands’ suicide ideation (OR 1.036; CI 95% 1.014–1.058) but not BIS-11 (OR 0.973; CI 95% 0.942–1.004). ConclusionUsed as proxy-reported assessment tools, BIS-11 showed better reliability than the BPAQ. However, both showed validity in Spanish population and could be included in psychological autopsy protocols.