Protective Factor For Suicidal Ideation Research Articles

Perceived responsiveness in suicidal ideation: An experience sampling study in psychiatric patients.

Perceived responsiveness, or the extent to which one feels understood, validated and cared for by close others, plays a crucial role in people's well-being. Can this interpersonal process also protect people at risk? We assessed whether fluctuations in suicidal ideation were associated with fluctuations in the degree of perceived responsiveness that psychiatric patients (admitted in the context of suicide or indicating suicidal ideation) experienced in daily interactions immediately after discharge. Fifty-seven patients reported on suicidal ideation (5 times a day) and perceived responsiveness (daily) for four consecutive weeks. The effects of established risk factors-thwarted belongingness, perceived burdensomeness, and hopelessness-were assessed as well. The more patients felt that close others had been responsive to them, the less suicidal ideation they reported. At low levels of thwarted belongingness, perceived burdensomeness, or hopelessness, perceived responsiveness seemed to play a protective role, negatively co-occurring with suicidal ideation. When thwarted belongingness, perceived burdensomeness, and hopelessness were high, perceived responsiveness did not have an effect. Perceived responsiveness could be a protective factor for suicidal ideation for people at risk only when they are experiencing low levels of negative perceptions. When experiencing highly negative perceptions, however, perceived responsiveness seems to matter less.

The association among thriving in life, quality of life, and suicidal ideation in Chinese urban older adults: the moderating effects of attitude toward own aging

BackgroundAs the global trend of population aging intensifies, the health and well-being of the older population has gradually become a focus of attention for the global community. This study assessed the status of thriving in life among Chinese urban older adults and identified its relationship with attitude toward own aging and quality of life (QoL). It also tested whether attitude toward own aging moderates the association between thriving in life and Qol or between thriving in life and suicidal ideation.MethodsPrimary data were collected through a cross-sectional survey among urban older adults from three provinces in China. They were invited to complete an anonymous survey using face-to-face interviews from December 2019 to January 2020. Data from 764 older adults were analyzed.ResultsApproximately 44.39% of participants reported positive responses toward the four domains of thriving in life. Thriving in life and attitude toward own aging had a significant association with QoL. Thriving in life was a protective factor for suicidal ideation for older adults. Moreover, attitude toward own aging moderated the association between thriving in life and QoL and that between thriving in life and suicidal ideation.ConclusionsChinese urban older adults were reportedly thriving in life, which contributed to increased QoL and reduced suicidal ideation. Notably, the study revealed that more positive attitudes towards own aging were associated with higher levels of thriving in life, better QoL, and reduced suicidal ideation. Targeted interventions for older adults should be devised to promote thriving in life and prevent negative attitudes of older people towards their own aging, further raising QoL and reducing suicidal ideation.

Positive and negative social media experiences and proximal risk for suicidal ideation in adolescents.

Social media (SM) has received considerable attention as a potential risk factor for adolescent suicide. Few empirical studies, however, have examined adolescents' daily negative and positive experiences on SM and its proximal impacts on suicidal ideation (SI), particularly using intensive monitoring designs. Adolescents (N = 60; 14-17 years; 49% girls; 62% LGBTQ+) recruited using SM across the United States and participated in an 8-week intensive monitoring protocol. Ecological momentary assessment (three brief surveys per day) asked about negative and positive SM experiences and SI (passive and active). Multilevel modelling was used to evaluate the within-person relationships between daily SM experiences (e.g. individual fluctuations compared to a person's average) and SI, controlling for average levels of SM experiences, SM use screen time, and lifetime SI. Significant within-person effects of negative and positive SM experiences were associated with days when adolescents had SI. Specifically, on days when teens endorsed more frequent negative SM experiences than usual, they were more likely to report SI. However, more positive SM experiences than usual were associated with a lower likelihood of having SI. There were no significant effects of SM use ('screen time') on SI or on the reverse associations of SI on next-day SM experiences. Results indicate that SM experiences may be dynamic and modifiable risk and protective factors for SI in adolescents, whereas there is no effect of SM screen time on SI. Our results highlight that targeting negative SM experiences and augmenting the positive experiences on SM may be critical targets to improve teens' mental health and prevent suicide, rather than focusing on limiting SM screen time.

Protective factors for suicidal ideation: a prospective study from adolescence to adulthood.

Adolescent suicidality is associated with negative outcomes in adulthood. Suicide prevention has traditionally focused on identifying risk factors, yet suicide rates have remained stable. With suicidality often going undetected-especially suicidal ideation, further knowledge about protective factors is needed. The main objective of this study was to investigate potential protective factors for suicidal ideation from adolescence to adulthood. The study employed longitudinal population survey data, "Youth and Mental Health Study" consisting of self-reports at two-time points (mean age 14.9, SD = 0.6 and 27.2, SD = 0.6) (n = 2423 and n = 1198). Protective factors (at individual, social and environmental level) were selected based on a priori knowledge. Internal consistency of scales was analyzed using McDonald's omega. We used a linear mixed model with suicidal ideation as the dependent variable, time-points, a protective factor variable and their interaction as covariates, and individual participant as random effects. We adjusted for sex and also conducted separate analyses for males and females. The Benjamini-Hochberg procedure was used to adjust p-values for multiple hypotheses. Investigated protective factors were associated with temporal change in suicidal ideation (significant interactions). For both sexes, less emotion-orientated coping, higher self-perception scores, greater levels of physical activity and higher school wellbeing/connectedness were protective factors for suicidal ideations. Secure attachment and higher family function were protective factors for females only. The effects in adolescence were mostly maintained in adulthood. In this study, several protective factors for suicidal ideation persisted into adulthood, with distinct differences between males and females.

Risk and protective factors for suicidal ideation and attempt: comparing gender diverse and cisgender youth

Transgender and gender diverse adolescents are at especially high risk for suicidal behavior compared with cisgender peers. Based on ideation-to-action models of suicide, study aims were to compare transgender and gender diverse (TGD) and cisgender youth on suicide risk and protective factors and identify gender differences in the strength of the associations between protective factors and suicide-related outcomes. Participants were n = 26,887 (n = 1352 TGD youth; n = 12,529 cis boys; n = 13,006 cis girls) 8th and 11th grade respondents on a state-representative school-based survey in Oregon in 2019. Consistent with prior studies, TGD youth more often reported suicidal ideation (45%) than cisgender boys (12%) and girls (24%). TGD youth demonstrated higher odds of risk factors (depression, bullying, parental rejection) and lower levels of protective factors (adult support, problem solving) than cisgender peers. These differences did not fully explain TGD adolescents’ higher odds of suicidal thoughts and behaviors. Results support the need for targeted prevention efforts for TGD youth.

Network analysis of risk and protective factors for suicidal ideation in adolescents

Adolescent suicidal ideation is influenced by numerous risk and protective factors. However, the manner in which these factors jointly impact adolescent suicidal ideation remains unclear. This study used network analysis to evaluate the associations between common risk and protective factors and suicidal ideation among adolescents, and to identify the key pathways connecting them. The study included 1992 adolescents aged 12–18 years from 13 Chinese middle schools, and scores on several scales (evaluating Psychological Suzhi, Positive and Negative Emotions, Perceived Social Support, Suicidal Ideation, Negative Life Events) were used to construct a network model. We constructed two models: a regularized partial correlation network and a Bayesian directed acyclic graph (DAG). The findings were as follows: (1) family support, significant others’ support and positive emotions negatively predicted suicidal ideation among adolescents, while other life events and negative emotions positively predicted suicidal ideation. (2) Being punished and relationship stress indirectly enhanced suicidal ideation. (3) The cognitive quality of Psychological Suzhi was located upstream and had an important influence on the entire network according to the DAG. (4) Suicidal ideation was a terminal node.

Factors related to suicidal ideation of schizophrenia patients in China: a study based on decision tree and logistic regression model

ABSTRACT This study aimed to investigate the factors associated with suicidal ideation in schizophrenia patients in China using decision tree and logistic regression models. From October 2020 to March 2022, patients with schizophrenia were chosen from Chifeng Anding Hospital and Daqing Third Hospital in Heilongjiang Province. A total of 300 patients with schizophrenia who met the inclusion criteria were investigated by questionnaire. The questionnaire covered general data, suicidal ideation, childhood trauma, social support, depressive symptoms and psychological resilience. Logistic regression analysis revealed that childhood trauma and depressive symptoms were risk factors for suicidal ideation in schizophrenia (OR = 2.330, 95%CI: 1.177 ~ 4.614; OR = 10.619, 95%CI: 5.199 ~ 21.688), while psychological resilience was a protective factor for suicidal ideation in schizophrenia (OR = 0.173, 95%CI: 0.073 ~ 0.409). The results of the decision tree model analysis demonstrated that depressive symptoms, psychological resilience and childhood trauma were influential factors for suicidal ideation in patients with schizophrenia (p < 0.05). The area under the ROC for the logistic regression model and the decision tree model were 0.868 (95% CI: 0.821 ~ 0.916) and 0.863 (95% CI: 0.814 ~ 0.912) respectively, indicating excellent accuracy of the models. Meanwhile, the logistic regression model had a sensitivity of 0.834 and a specificity of 0.743 when the Youden index was at its maximum. The decision tree model had a sensitivity of 0.768 and a specificity of 0.8. Decision trees in combination with logistic regression models are of high value in the study of factors influencing suicidal ideation in schizophrenia patients.

6.63 Protective Factors for Suicidal Ideation: A Prospective Cohort Study From Adolescence to Adulthood

6.63 Protective Factors for Suicidal Ideation: A Prospective Cohort Study From Adolescence to Adulthood

Psychological Risk and Protective Factors for Suicidal Ideation: A Study in an Adolescent Sample in an Insular Context.

Adolescents are at risk of suicide. As suicide is a multifactorial process, risk and protective factors are relevant constructs for suicide prediction. This study explored the effects of risk and protective factors on suicidal ideation in adolescents on the island of São Miguel (Azores). A sample of 750 adolescents (male: n=358; 47.7%; mean age=14.67 years; standard deviation=1.85 years) from the island of São Miguel (Azores) completed several measures related to suicidal ideation and associated factors. Using a cross-sectional design, this study conducted descriptive, correlational, predictive, mediation, and moderation analyses. Adolescents generally displayed high levels of risk and protective factors; an indicative proportion exhibited significant suicidal ideation with females presenting the greatest vulnerability. Furthermore, the results highlight that depression is the best predictor of suicidal ideation, however, the association between these variables is mediated. The data corroborate that the suicidal reality of adolescents in the Autonomous Region of the Azores is worrisome. Having substantiated the complexity of the suicidal context in young people in the present research, the need to continue studying risk/protective factors in this area is supported.

A Bayesian network analysis of psychosocial risk and protective factors for suicidal ideation.

The aim of this study was to investigate and model the interactions between a range of risk and protective factors for suicidal ideation using general population data collected during the critical phase of the COVID-19 pandemic. Bayesian network analyses were applied to cross-sectional data collected 1 month after the COVID-19 lockdown measures were implemented in Austria and the United Kingdom. In nationally representative samples (n = 1,005 Austria; n = 1,006 UK), sociodemographic features and a multi-domain battery of health, wellbeing and quality of life (QOL) measures were completed. Predictive accuracy was examined using the area under the curve (AUC) within-sample (country) and out-of-sample. The AUC of the Bayesian network models were ≥ 0.84 within-sample and ≥0.79 out-of-sample, explaining close to 50% of variability in suicidal ideation. In total, 15 interrelated risk and protective factors were identified. Seven of these factors were replicated in both countries: depressive symptoms, loneliness, anxiety symptoms, self-efficacy, resilience, QOL physical health, and QOL living environment. Bayesian network models had high predictive accuracy. Several psychosocial risk and protective factors have complex interrelationships that influence suicidal ideation. It is possible to predict suicidal risk with high accuracy using this information.

Suicidal Ideation of Healthcare Workers During COVID-19: An Ecological Momentary Assessment

Introduction: The COVID-19 pandemic had an impact on the psychological health of healthcare workers (HCWs). Cross-sectional studies report suicidal ideation in this population during this period, but no longitudinal study has examined the evolution of these ideas over time.&#x0D; &#x0D; Objectives: To assess the evolution of suicidal ideation of HCWs during the first two waves of the COVID-19 pandemic among Quebec (Canada) HCWs and to identify the risk factors involved.&#x0D; &#x0D; Methods: A longitudinal study among Quebec (Canada) HCWs using ecological momentary assessment was conducted between May 8, 2020, and March 31, 2021 (corresponding to the second half of the first wave to the end of the second). Participants (n=865) answered weekly questions related to anxiety (GAD-7), depression (PHQ-9), suicidal ideation (PHQ-9 Q.9), exposure to COVID-19, exposure to COVID-19-related deaths, their infection status and that of their co-workers and loved ones, as well as the amount of time they spent consuming news related to COVID-19.&#x0D; &#x0D; Results: Proportion of suicidal ideation increased from May to June 2020 (second half of the first wave) peaking at 18% before declining up to March 2021. Anxiety and depression symptoms severity increased those ideations as well as having a colleague confirmed positive to COVID-19. Social support does not appear to be a protective factor for suicidal ideation. Suicidal thoughts are associated with media consumption and appear to be mediated by the presence of clinical distress expressed as depressive or anxiety states.&#x0D; &#x0D; Discussion and conclusion: Media consumption in a pandemic context is associated with anxiety and depression, the more severe states of which may express suicidal ideation. Without inferring causality relationship, it seems advisable for HCWs to limit their media exposure during a disaster such as a pandemic.

Association between psychological pain and suicidal ideation among men with substance use disorder: a moderated mediation model

Previous studies have found that people with substance use disorder are associated with significantly higher odds of suicidal ideation than the general population. Psychological pain and emotional regulation are considered protective factors for suicidal ideation, but the interaction process is not clear. In this study, we investigated the effects of psychological pain on suicidal ideation and constructed a moderated mediation model. 445 men with substance use disorder in China were recruited to complete the Chinese version of the Psychological Pain Scale, Regulatory Emotional Self-efficacy Scale, Suicidal Ideation Scale, and Intolerance of Uncertainty Scale. The results demonstrated that psychological pain significantly and positively predicted suicidal ideation among people with substance use disorder, and that regulatory emotional self-efficacy played a mediating role between psychological pain and suicidal ideation. Intolerance of uncertainty moderated the top and bottom halves of the intermediate process paths. This study suggests that intolerance of uncertainty and regulatory emotional self-efficacy can be improved by interventions among people with substance use disorder, which in turn can reduce their suicidal ideation and improve quality of life.

Risk factors for suicidal ideation in a chronic illness

Suicide is an urgent concern for people with chronic illnesses, particularly for those with myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). Prior work has examined suicide risk in this illness, but few studies have examined specific risk factors. This study uses binary logistic regression to identify physical, social, and demographic risk and protective factors for suicidal ideation in ME/CFS (N = 559). The results indicate sleep-related symptoms, stigma, disability status, physical functioning, and marital status as risk factors for suicidal ideation in this group. These findings highlight the importance of education, de-stigmatization, and the search for effective disease-modifying treatments for ME/CFS.

Correlates of suicidal ideation in rural Chinese junior high school left-behind children: A socioecological resilience framework.

IntroductionSuicide is one of the top five causes of adolescent mortality around the world. The socioecological resilience framework in explaining the risk factors and protective factors for suicidal ideation in left-behind children (LBC) has not been well explored. The current study aims to compare the prevalence of suicidal ideation in LBC and non-LBC, and explore its correlations with resilience factors among LBC.MethodologyThis study was part of an epidemiological survey conducted by UNICEF exploring mental health outcomes in left-behind children. We implemented a cross-sectional study collecting data from 11 provinces and 1 municipal, with 5,026 participants (3,359 LBC, 1,667 controls) in year one junior high school living in impoverished areas of rural China. Data on suicidal ideation, self-harm, resilience factors including health-risk behaviors, psychological wellbeing as it was measured by the Strengths and Difficulties Questionnaire, peer relationship within the school environment, and family support were collected.ResultsOverall prevalence of suicidal ideation among LBC was 7.2% which is significantly different from 5.5% reported by NLBC (χ2 = 4.854, p = 0.028). LBC reported a higher prevalence of self-harm (16.4%) than NLBC (13.0%; χ2 = 10.232, p = 0.001), but there was no difference in the prevalence of suicide plan, suicide attempt or help-seeking. LBC had significantly poorer psychological feeling, and greater emotional and behavioral difficulties peer relationship in the school environment than controls. In the multiple logistic regression, history of self-harm was the greatest predictor for suicidal ideation among LBC (OR = 2.078, 95% CI: 1.394–3.100, p < 0.001). Health risk behavior including previous smoking attempt, poor psychological feeling, and emotional and behavior difficulties, and poor peer relationship within school environment, were also significant risk factors for suicidal ideation among LBC.ConclusionThe prevalence of suicidal ideation and self-harm was greater among left-behind than non-left-behind children. Our results show resilience factors including previous self-harm, emotional and behavioral problems, smoking, and poor peer relationship are significantly associated with suicidal ideation in left-behind adolescents.

The prevalence of suicide ideation and predictive factors among pregnant women in the third trimester

BackgroundPregnancy is a period for women undergo major physical and psychological changes. Suicide is a cause of maternal death and suicidal ideation is a key factor in suicidal behavior. The purpose of this study was to investigate the prevalence of suicidal ideation in the third trimester and associated predictors including psychological factors such as attachment.MethodsA cross-sectional study included 432 pregnant women in the third trimester of pregnancy was conducted in a tertiary hospital. The Edinburgh Postpartum Depression Scale (EPDS) was used to assess prenatal depression and suicidal ideation. The Zung Self-Rating Anxiety Scale (SAS) and Experience of Close Relationship (ECR) scale were used to assess anxiety and attachment respectively.ResultsThe results showed that the EPDS scale screened 6.71% of pregnant women with suicidal ideation. Compared with those without suicidal ideation, pregnant women with suicidal ideation had a higher prevalence of insecure attachment, higher scores on the two dimensions of attachment (attachment avoidance and attachment anxiety), and higher prevalence of prenatal depression and anxiety. Binary logistic regression showed that marital satisfaction was a protective factor for suicidal ideation, while prenatal depression, prenatal anxiety and attachment anxiety were risk factors for suicidal ideation.ConclusionsThe suicidal ideation among pregnant women was high, which should be given more attention. In the process of preventing and intervening suicidal ideation, in addition to the emotional state of pregnant women, their psychological factors such as attachment anxiety should also be considered.

Protective factors for suicidal ideation among Black adolescents indirectly exposed to community violence.

Community violence exposure has been identified as a risk factor for Black youth suicide ideation. However, little is known about factors that protect community violence exposed youth against suicide ideation. The current study examined associations between knowledge of family member and peers' community violence exposure and Black youth's subsequent suicidal ideation, and investigated self-worth and social support as protective factors. Participants were a community sample of Black youth (N=447, 47.4% female; Mage=11.77, SD=0.35) who reported about community violence exposure, self-worth, social support, and suicide ideation in grades 6 and 7. Regression analyses revealed that grade 6knowledge of family member and peers' community violence exposure was associated with increases in suicide ideation assessed in grade 7. Self-worth attenuated the association between knowledge of others' community violence exposure and suicide ideation for male adolescents. For female adolescents, social support attenuated the association between knowledge of others' community violence and suicide ideation. Findings highlight the consequential impact of knowledge about community violence for Black youth's suicidal ideation. Enhancing protective factors for Black youth is an important target for intervening with exposure to violence and reducing suicide ideation.

Core self-evaluation as mediator between depressive symptoms and suicidal ideation in adolescents

ObjectivesTo explore the role of core self-evaluation in mediating between depressive symptoms and suicidal ideation in Chinese adolescents. MethodsWe used the cluster sampling method to analyze 11,563 students from five primary and secondary schools in China for depressive symptoms, core self-evaluation, and suicidal ideation using the following scoring scales: Core Self-Evaluation Scale (CSES), Center for Epidemiologic Survey Depression Scale (CES-D), the Second Edition of the Beck Depression Inventory (BDI- II), Screen for Child Anxiety Related Emotional Disorders (SCARED), and Adolescent Self-Rating Life Events Checklist (ASLEC). ResultsThe incidence of depression was 29.7%; anxiety, 34.2%; and suicidal ideation, 28.0%. Core self-evaluation was a protective factor for suicidal ideation [OR 0.947, 95% CI 0.937–0.959, p<0.001]. Conversely, depression as measured by the CSES score was a risk factor for suicidal ideation (OR 1.084, 95% CI 1.073–1.096, p<0.001), as were anxiety as measured by the SCARED score (OR 1.011, 95% CI 1.006–1.016, p<0.001) and adolescent life events according to ASLEC score groups (OR 1.524, 95% CI 1.434–1.621, p<0.001). Core self-evaluation mediated the relationship between depression and suicidal ideation with an effect size of 13.9%. ConclusionsBetter core self-evaluation is a protective factor against suicidal ideation and mediates the relationship between depression and suicidal ideation. We may be able to reduce the risk of suicidal ideation and therefore suicide among adolescents by improving their core self-evaluation.

Physical disability, low self-esteem, and suicidal ideation among Chinese nursing home residents: the moderating role of resilience

Objectives This study aimed to investigate the mediating role of self-esteem in the relationship between physical disability and suicidal ideation, and whether the mediation effect was moderated by resilience among nursing home residents. Methods Participants were 538 nursing home residents recruited from 37 nursing homes in Jinan, China (mean age = 78.13 years, SD = 8.72). The Lawton and Brody Activities of Daily Living Scale, Rosenberg Self-Esteem Scale, 10-item version of the Connor-Davidson Resilience Scale, and Beck Suicidal Ideation Inventory-Chinese Version were used. Mediation and moderated mediation analyses were performed using Models 4 and 15 of the PROCESS macro for SPSS. Results The prevalence of suicidal ideation among the nursing home residents was 14.90%. The mediation analysis showed that self-esteem partially mediated the association between physical disability and suicidal ideation. Resilience was a protective factor for suicidal ideation and moderated the relationship between physical disability and suicidal ideation, and between self-esteem and suicidal ideation. Conclusion Both physical disability and lower self-esteem are important in understanding the development of suicidal ideation among nursing home residents. Improving resilience may be crucial for suicide prevention.

Self-Compassion Moderates the Association Between Body Dissatisfaction and Suicidal Ideation in Adolescents: A Cross-Sectional Study.

Identifying risk and protective factors for suicidal ideation during adolescence is essential for suicide prevention. One potential risk factor is body dissatisfaction which appears to peak during adolescence. The present study investigated the self-compassion buffering effects in the relationship between body dissatisfaction and suicidal ideation. A convenience sample comprising 580 adolescents (mean age 16.35 years; SD = .87; range 14–18 years) was recruited from public schools. The results indicated a strong positive association between body dissatisfaction and suicidal ideation (Cohen’s f 2 = .25). The association was significantly moderated by the self-compassion (β = − .16, SE = .04, p = .01, t = 2.4.34, .95% CI [− .16, − .01]). Structural equation modeling analysis showed that the lack of self-kindness was associated with a moderate suicidal ideation level (Cohen’s f 2 = .14). Also, higher levels of self-judgment predicted suicidal ideation with a moderate to large effect size (Cohen’s f 2 = .28). The findings suggest that therapeutic programs designed to develop self-compassion should be implemented to reduce the risk of suicidal ideation among adolescents with body dissatisfaction. The findings empirically show that a higher degree of self-judgment is strongly associated with suicidal thoughts among adolescents, which must be systematically addressed in clinical studies on suicidal risk.Supplementary InformationThe online version contains supplementary material available at 10.1007/s11469-021-00727-4.

Social support as protective factor for suicidal ideation during treatment for substance abuse: Differential effects across treatment modalities

Substance abuse treatment constitutes a period of increased risk for suicide. It is unclear if social support during treatment influences suicide risk during treatment, or how this is characterized across different treatment modalities. The present study involved secondary analyses of the Drug Abuse Treatment Outcome Study, a large, longitudinal multi-site study conducted from 1991 to 1994 that involved interviews with patients at various treatment programs reporting on experiences while receiving substance abuse treatment. Data from people in inpatient (n = 2530) and outpatient treatment (n = 2568) programs were analyzed to determine the extent that various indicators of social support influenced odds of having suicidal ideation during treatment. Across both treatment modalities, ongoing interpersonal problems and patient perception of their performance in relationships significantly predicted odds of suicidal ideation one month into treatment. Contact with one's social support system during treatment only significantly decreased odds of suicidal ideation for inpatients. Relationship status did not significantly influence odds of suicidal ideation in either group. Overall, social support appears to be associated with decreased risk for suicidal ideation during substance abuse treatment, and certain indicators of social support may be especially important for specific treatment modalities.