Recent Suicide Research Articles

Religiosity, Spirituality, Meaning-Making, and Suicidality in Psychiatric Patients and Suicide Attempters: A Systematic Review and Meta-Analysis

Abstract Learning Objective After participating in this CME activity, the psychiatrist should be better able to: • Explain current understanding of how religiosity, spirituality, and meaning-making (R/S/M) affect patients with psychiatric diagnoses. Introduction R/S/M generally protect against suicidality and suicide. Thus far, reviews on the topic have largely been descriptive, and there are no meta-analyses focused on psychiatric patients. This study systematically evaluates all empirical evidence on R/S/M’s potential influences on suicidality for psychiatric patients and recent suicide attempters. Methods A systematic PROSPERO preregistered search following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses protocol was performed in MEDLINE and PsycInfo. Quantitative studies until 31 December 2022 on R/S/M and suicidality in psychiatric populations and recent suicide attempters were selected; psychological autopsy studies were excluded. Results The search identified 4,374 studies for screening. This resulted in 108 eligible studies for the systematic review and 75 studies for the meta-analysis, including 231 effect sizes (ES) and 17,561 subjects. Research focused mainly on the emotional, moral, and ritual aspects of R/S/M. Most research was cross-sectional; repeated R/S/M assessments were rarely reported. A combined significant and negative ES (Fisher Z = -0.13, p = .006, equivalent to Cohen's d = -0.26) was found for all good- and fair-quality studies. Conclusion Overall, R/S/M was associated with lowering suicidality. Maladaptive-distressing dimensions of R/S/M correlated with higher rates of suicidality (e.g., religious struggles). The explanatory value was limited by the predominantly cross-sectional nature of ESs. Registration and funding PROSPERO registration 2023 CRD42023398692; there was no funding involved.

Research on cyberbullying and suicide: a bibliometric analysis

AbstractSuicide is a global mental health problem. In recent years, suicidal ideation, suicide attempts and suicides have increased in children and adolescents. In this population, cyberbullying is a public health problem that has grown along the increase in use of devices with internet access. Cybervictimization is related to negative health effects, even including suicidal ideation or suicide in cyberbullied individuals. This study is the first bibliometric analysis on scientific literature related to cyberbullying and suicide based on the traditional laws of bibliometrics. The aim was to generate a global overview of the research related to this object of study. We analysed 242 documents published in journals indexed in the Web of Science, examining the trend followed by annual publications, identifying the prolific (most productive) and prominent (prolific co‐authors with one or more papers between most cited papers) co‐authors, leading countries and journals, the most cited documents and the most used author keywords. Annual publications followed an exponential growth trend (R2 = 89.2%), meaning that there is a great interest in the scientific community for this study object. International Journal of Environmental Research and Public Health and Psychiatry Research were the journals with most document published. Baiden, P. (prolific), Kowalski, R. (most cited), Hinjuja, S. and Patchin, J. (prominents) were the most highlighted co‐authors, reference authors on the subject. Most scientific output originated in the USA. Five thematic lines were identified among the author keywords. The results of this research show the growing interest of the scientific community in this topic, along with useful information for researchers and publishers, identifying relevant co‐authors, journals interested in the topic and emerging lines of research, highlighting self‐harm, cyber‐victimisation, suicide risks and suicidal behaviours as the most recent thematic lines.

EEG oscillations in recent suicide attempters: Assessing responses to positive and negative future imagination tasks

BackgroundOur goal is to uncover Electroencephalography (EEG) power spectrum patterns during imagination tasks in individuals who attempted suicide within the past 1–4 weeks, addressing gaps in understanding the neural correlates of future imagination in suicidal behavior. MethodsThis case-control study comprised a total of 60 participants, consisting of 47 females and 13 males. The sample comprised three groups: Attempted Suicide + Major Depressive Disorder (SA+MDD), Major Depressive Disorder (MDD), and Healthy Controls (HC). To assess participants' future imagination, a unique approach called the Positive and Negative Future Imagination Task was designed, which involved scenario visualization concurrent with EEG recording. Statistical analyses included ANOVA with post-hoc pairwise comparisons to compare EEG power spectrum between three groups. ResultsIt was observed that the SA+MDD group experienced significantly increased theta frequency band in the right frontocentral regions when compared to the MDD group during both positive and negative imagination tasks (P-value < 0.05). Furthermore, increased gamma activity was observed in the SA+MDD group compared to the HC group, predominantly in the right frontocentral areas during both imagination tasks. ConclusionThe results of this study indicate that individuals who have recently attempted suicide exhibit heightened neural activity in the frontocentral regions of the right hemisphere of the brain, specifically in theta and gamma band frequencies, when contemplating both positive and negative aspects of the future. These findings, in the context of behavioral tasks may indicate a decrease in the ability to envision a positive future and an increase in visualizing a negative future.

Performance of Machine Learning Suicide Risk Models in an American Indian Population

Few suicide risk identification tools have been developed specifically for American Indian and Alaska Native populations, even though these populations face the starkest suicide-related inequities. To examine the accuracy of existing machine learning models in a majority American Indian population. This prognostic study used secondary data analysis of electronic health record data collected from January 1, 2017, to December 31, 2021. Existing models from the Mental Health Research Network (MHRN) and Vanderbilt University (VU) were fitted. Models were compared with an augmented screening indicator that included any previous attempt, recent suicidal ideation, or a recent positive suicide risk screen result. The comparison was based on the area under the receiver operating characteristic curve (AUROC). The study was performed in partnership with a tribe and local Indian Health Service (IHS) in the Southwest. All patients were 18 years or older with at least 1 encounter with the IHS unit during the study period. Data were analyzed between October 6, 2022, and July 29, 2024. Suicide attempts or deaths within 90 days. Model performance was compared based on the ability to distinguish between those with a suicide attempt or death within 90 days of their last IHS visit with those without this outcome. Of 16 835 patients (mean [SD] age, 40.0 [17.5] years; 8660 [51.4%] female; 14 251 [84.7%] American Indian), 324 patients (1.9%) had at least 1 suicide attempt, and 37 patients (0.2%) died by suicide. The MHRN model had an AUROC value of 0.81 (95% CI, 0.77-0.85) for 90-day suicide attempts, whereas the VU model had an AUROC value of 0.68 (95% CI, 0.64-0.72), and the augmented screening indicator had an AUROC value of 0.66 (95% CI, 0.63-0.70). Calibration was poor for both models but improved after recalibration. This prognostic study found that existing risk identification models for suicide prevention held promise when applied to new contexts and performed better than relying on a combined indictor of a positive suicide risk screen result, history of attempt, and recent suicidal ideation.

A study protocol of the effectiveness of the Attempted Suicide Short Intervention Program (ASSIP) for recent suicide attempters: a randomized controlled trial

BackgroundGiven the limited research focusing on psychotherapeutic interventions for suicide attempters, it is noteworthy that the Attempted Suicide Short Intervention Program (ASSIP) has demonstrated promising results in previous studies. In this investigation, we aim to evaluate the effectiveness of ASSIP across diverse healthcare settings, outlining the study design and planned evaluation.MethodsUsing a Randomized Controlled Trial (RCT) design with four assessment points (baseline, 3, 12- and 24-month follow-up), we aim to assess the effect of the 3-session psychotherapeutic intervention and hereafter brief contact via structured letters during 2 years in a clinical sample of recent suicide attempters (suicide attempts within three months before inclusion). Participants are randomly assigned to one of two groups; treatment as usual plus ASSIP or the control condition, treatment as usual. Assessments include measures of suicidal intent, coping, symptoms of depression, quality of life, self-stigma, and sick leave. The primary outcome is suicide attempt(s) within 3, 12, and 24 months and the secondary outcome is suicidal ideation within the same time frames after study inclusion.DiscussionFindings from this study will provide novel insights regarding the effects of ASSIP on not only subsequent suicidal behavior but also other outcomes including self-stigma, quality of life, social network, sick leave, and symptoms of depression.Trial registrationThe trial was registered at ClinicalTrial.gov NCT04746261 on 2020-10-15.

Brooding, reflection, and anger rumination in late life suicidal behavior

BackgroundCurrent literature on age-specific risk factors for suicide in older adulthood is lacking. One risk factor for younger-life suicide, rumination, has not been extensively studied in older adults, but from prior research, may be more relevant to late-life vs. early life suicide. The current study investigated how multiple subtypes of rumination (i.e., brooding, reflection, and anger rumination) relate to suicidal ideation and recent suicidal behavior in late life. Methods378 participants aged 50–90 (mean age 63.4, SD 7.5) were recruited into a case-control study examining suicide in older adults. Participants were recruited into three groups: 1) depressed adults who had made a recent (past two years) suicide attempt, 2) those with depression but no suicide attempt, and 3) a healthy comparison group. Among depressed groups, we examined relationships between rumination types, trait anger, depression, and suicidal ideation. Then, we conducted logistic regression to test which variables were related to having made a suicide attempt in the past two years among those with current suicidal ideation. ResultsAll forms of rumination were related to depression. Brooding was related to ideation severity, but only depression severity related to presence of ideation. Anger rumination and ideation severity each contributed unique variance in their prediction of recent suicide attempts. LimitationsOur cross-section design does not allow for causal claims; future studies should consider using ecological momentary assessment approaches. ConclusionsTreatments to decrease rumination without an intense cognitive component should be considered for late-life patients.

Typologies of Psychiatric Diagnoses Among Inpatients with Recent Suicide Attempts

Objective Psychiatric multimorbidity is a well-documented risk factor for suicide. However, diagnostic heterogeneity and patterns of comorbidity likely exists within the population of those who attempt suicide. Person-centered statistical approaches, such as latent class analysis (LCA), extract distinguishable groups differentiated by prevalence and comorbidity of psychiatric disorders. Method The present study used LCA to identify typologies of psychiatric heterogeneity in a sample of 213 inpatients (M age = 33.04 [SD = 12.67]; 57.3% female; 62.4% White; 23.9% Hispanic/Latino) with a history of suicide attempt who were recruited for a suicide prevention clinical trial. Class differences in suicide history characteristics; demographic characteristics; and cognitive-affective and behavioral risk factors, obtained from an initial evaluation involving the administration of a semi-structured diagnostic interview, suicide risk assessment, and battery of self-report measures, were explored. Results LCA identified three classes in the best-fitting solution: Depressive-High Comorbidity (n = 68), Depressive-Low Comorbidity (n = 86), and Bipolar (n = 59). The Depressive-Low Comorbidity class reported less severe suicidal ideation (p < .001), anxiety (p < .001), stress (p < .001), unlovability beliefs (p = .006), and impulsivity (p < .001). The Depressive-Low Comorbidity class also reported fewer actual attempts than the Bipolar class (p = .001) and fewer interrupted attempts than the Depressive-High Comorbidity class (p = .004). Conclusions The Depressive-High Comorbidity and Bipolar classes consistently endorsed higher levels of suicide risk factors. These findings may help to illuminate typologies of suicide attempters with unique clinical needs, which is an essential step toward personalized medicine.

Relationship Between the Feeling of Emptiness and Suicide Reattempt: Conclusions From Cross-Sectional and Longitudinal Analyses.

The feeling of emptiness is a complex subjective experience considered relevant in the suicidal process, acting as a risk factor for suicide ideation, attempts and even reattempts. However, empirical studies are still scarce. This study has three objectives: to compare emptiness levels in healthy people and those with suicide attempts; to compare the emptiness level between people with a single suicide attempt and multiple suicide attempts at baseline; and to study emptiness as a risk factor for the appearance of new suicidal attempts after an index one. In the study, 382 healthy controls and 58 participants with a recent suicide attempt (in the past 15 days) participated. All completed the feeling of emptiness scale (FES). Information was also collected on sociodemographic characteristics and history of suicide attempts. First, the control sample scores were compared with those of the clinical sample. Later, the single attempt and reattempt groups (any amount greater than one attempt at baseline) were compared. Finally, the clinical sample was followed for 1 year and 3 months (through clinical records). Survival analysis was performed. The clinical group obtained higher scores across the FES subscales, even when controlling for other relevant variables (p < 0.01). When comparing people with one versus several attempts, differences were also observed in all subscales except one, the reattempt group getting higher scores (p < 0.05). Regarding the survival analysis, the feeling of emptiness was significantly associated with the risk of reattempt (HR = 1.04; p < 0.05). All people who reattempted during follow-up belonged to the reattempt group at baseline. People who have attempted suicide present higher emptiness scores. Furthermore, emptiness appears to significantly predict the occurrence of new attempts at follow-up. The feeling of emptiness may be associated with the lack of vital meaning and disconnection from others, fundamental aspects of the ideation-to-action suicide models. Including emptiness in suicide assessments could increase clinicians' predictive ability.

Frontal Activity of Recent Suicide Attempters: EEG spectrum Power Performing Raven Task.

Background: Deficits in problem-solving may be related to vulnerability to suicidal behavior. We aimed to identify the electroencephalographic (EEG) power spectrum associated with the performance of the Raven as a reasoning/problem-solving task among individuals with recent suicide attempts. Methods: This study with the case-control method, consisted of 61 participants who were assigned to three groups: Suicide attempt + Major Depressive Disorder (SA + MDD), Major Depressive Disorder (MDD), and Healthy Control (HC). All participants underwent clinical evaluations and problem-solving abilities. Subsequently, EEG signals were recorded while performing the Raven task. Results: The SA + MDD and MDD groups were significantly different from the HC group in terms of anxiety, reasons for life, and hopelessness. Regarding brain oscillations in performing the raven task, increased theta, gamma, and betha power extending over the frontal areas, including anterior prefrontal cortex, dlPFC, pre-SMA, inferior frontal cortex, and medial prefrontal cortex, was significant in SA + MDD compared with other groups. The alpha wave was more prominent in the left frontal, particularly in dlPFC in SA + MDD. Compared to the MDD group, the SA + MDD group had a shorter reaction time, while their response accuracy did not differ significantly. Conclusions: Suicidal patients have more frontal activity in planning and executive function than the two other groups. Nevertheless, it seems that reduced activity in the left frontal region, which plays a crucial role in managing emotional distress, can contribute to suicidal tendencies among vulnerable individuals. Limitation The small sample size and chosen difficult trials for the Raven task were the most limitations of the study.

Adaptation and validation of a suicide-focused Word Sentence Association Paradigm to assess suicide-specific interpretation biases

The cognitive model of suicide proposes that biased cognitive processes contribute to suicidal thoughts and behaviors, and initial evidence suggests that attentional bias to suicide-congruent cues may predict suicidal behavior beyond established clinical risk factors. To date, much less work has explored the potential role of interpretation biases in the development and prediction of suicide risk. The present study assessed the psychometric properties, including reliability, concurrent validity, and predictive validity, of a novel adaptation of the Word Sentence Association Paradigm (WSAP) to assess suicide-suicide interpretation biases. In a sample of 239 psychiatric inpatients, including patients with no recent suicidal ideation or lifetime attempts (n = 35), those with recent suicide attempts (n = 29), and those with recent suicidal ideation (n = 174), participants completed the modified WSAP as well as self-reported suicidal ideation and attempts for the subsequent 6 months. Although the WSAP demonstrated good reliability, evidence of concurrent and prospective validity (in terms of self-reported suicidal ideation and attempts) was limited. Specifically, the clinical groups did not differ from one another on any measure of interpretation bias, nor did suicide-specific interpretation endorsements predict concurrent or future suicidal ideation when controlling for dysphoric interpretation bias. However, suicide-specific interpretation biases were uniquely associated with a history of a lifetime suicide attempt. Future work should further clarify the extent and specificity of the relationship between suicide-specific interpretation biases and clinical outcomes.

Social Support Somewhat Mitigates Grieving Problems of Recent Suicide Loss Survivors

Social Support Somewhat Mitigates Grieving Problems of Recent Suicide Loss Survivors

Feasibility, Safety, and Acceptability of Cognitive Processing Therapy for PTSD Following a Recent Suicide Attempt: A Case Study

While cognitive processing therapy (CPT) has been found to be highly effective in the treatment of posttraumatic stress disorder (PTSD) and comorbid suicidal ideation, it is unknown how soon after a suicide attempt this treatment may be safe and effective. This case study investigates the effectiveness of weekly, telehealth-delivered CPT for a client with PTSD following a suicide attempt on the anniversary of a traumatic event. Results indicate a clinically meaningful reduction in PTSD symptoms and loss of PTSD diagnosis, as measured by the PTSD Checklist for DSM-5 (PCL-5), and a lack of further suicidal ideation or attempts. These results were maintained at long-term follow-ups at 1-, 3-, and 12-month periods. Qualitative data from the client further supported the effectiveness and acceptability of treatment. This case study suggests the potential of CPT as a valuable intervention for individuals with PTSD recovering from suicide attempts and highlights the importance of further research in this area. In support of this, the case study also suggests the use of nuanced suicide risk assessments, such as the fluid vulnerability theory (FVT), to respond to fluctuations in suicide risk in high-risk clients.

Suicide among Veterans in Veterans Health Administration care: Differences in methods by tier of predicted suicide risk

Veterans' suicide rates exceed those of non-Veteran adults, and Veteran suicides more often involve firearms. However, the relationship between Veteran characteristics and suicide method is not well understood. Using the Veteran Health Administration suicide prediction algorithm, we assessed differences in suicide method by predicted risk among Veteran suicide decedents. Significant predictors of firearm involvement included lower algorithm-predicted suicide risk, no recent suicide attempts, male sex, and older age. Non-firearm methods were most common at high tiers of suicide risk. Firearm safety counseling is important for all Veterans and non-firearm lethal means safety counseling may be particularly important for high-risk Veterans.

Can profiles of behaviors occurring within 48 h of a suicide attempt predict future severity of suicidal thoughts and reattempt?: An examination of hospitalized patients 12 Months post-discharge

Behavioral warning signs (WS) are near-term changes within individuals, which aid in determining imminent risk for suicide attempts. However, those who attempt suicide differ in their engagement of WS, and it is unclear if these differences relate to future risk of suicidal behavior. Using a sample of 132 adults presenting to a hospital following a suicide attempt, the current study sought to determine if differences in engagement in WS for the index attempt prospectively predicted suicide attempt, frequency of ideation, and intensity of suicide ideation 12 months post discharge. Latent class analyses (LCAs) conducted on 6 behaviors (i.e., alcohol use, nightmares, interpersonal negative life events, suicide communication, risky behavior, low sleep, and high sleep) found a 5-class solution optimally fit the data. One identified class, characterized by engagement in risky behaviors the hours before an attempt differed from other identified classes in terms of risk for future suicidal ideation and behaviors. More specifically, participants in “High Risky Behavior” class had higher rates of 12-month suicide reattempt, significantly more frequent suicide ideation, and significantly worse intensity of suicide ideation during the 12 months following their index attempt compared to participants endorsing typical patterns of WS. These results held when adjusting for various traditional baseline covariates (e.g., depressive symptoms). The current study demonstrates that patterns of behavioral WS may be utilized as their own prognostic indicator of future suicidal ideation and behaviors among high-risk individuals reporting a recent suicide attempt, which can inform post-discharge clinical intervention and prevention efforts.

Mental health and wellbeing outcomes associated with social, medical, and legal gender affirmation among trans young people in Australia

Background Gender affirmation is known to improve mental health among trans adults, but its impact on young people has been questioned. This study examined the mental health outcomes associated with social, medical, and legal gender affirmation among trans young people in Australia. Methods Data from 1697 trans young people aged 14–21 who participated in an Australian national survey were analyzed using multivariable logistic regression analyses. We measured associations between gender affirmation and various mental health variables, including levels of happiness, psychological distress, anxiety, self-harm and recent suicidal ideation and suicide attempts. Associations between gender affirmation and young people’s wellbeing, including experiences of verbal harassment, homelessness, and drug use were also examined. Results Participants who had affirmed their gender legally and medically (via hormone therapy or surgery/ies) reported lower levels of anxiety and psychological distress, while legal gender affirmation was associated with lower suicidal ideation. Social affirmation was not directly associated with wellbeing outcomes but was linked to an increased likelihood of verbal harassment and homelessness. All forms of gender affirmation were associated with increased drug use, which likely reflects the greater opportunities for social connection and LGBTQ-community involvement that trans young people experience when they take steps to affirm their gender. Conclusion All forms of gender affirmation were positively associated with the wellbeing of trans young people. Though young people who had socially affirmed their gender faced higher likelihoods of experiencing verbal harassment and homelessness, this is likely linked to their increased visibility and subsequent vulnerability to discrimination. These findings highlight the need for targeted interventions to address transphobia and discrimination. A comprehensive approach to supporting the wellbeing of trans young people should include legal, medical, and social affirmation, as well as addressing potential negative outcomes via societal education.

Do measures of social support and social distress share general factors associated with suicidal ideation and attempts?

Aspects of social relationships have variably been associated with suicidal ideation (SI) and suicide attempts (SAs). This study assessed whether social support and social distress measures have general factors versus measure-specific factors that are associated with suicide risk. Adults (N = 455, 60.0% female), admitted to psychiatric inpatient units following a recent suicide attempt or active SI, completed assessments of social support (emotional support, instrumental support, friendship, perceived support from significant others, friends, family) and social distress (loneliness, perceived rejection, perceived burdensomeness, thwarted belongingness). Bifactor modeling examined general and specific factors of social support and distress in relation to SI (week prior to hospitalization, via the Beck Scale for SI) and SAs (past 30 days, via the Columbia Suicide Severity Rating Scale). SI was significantly associated with the general social support (B = -1.51), the general social distress (B = 1.67), and the specific perceived burdensomeness (B = 1.57) factors. SAs were significantly associated with the specific Perceived Rejection (OR = 1.05) and Thwarted Belongingness (OR = 0.91) factors. General social support and social distress were associated with SI but not recent SAs. Specific social distress factors were also related to SI and SAs controlling for general social distress, suggesting areas for future interventions.

Gender differences in risk and resilience for suicidal thoughts and behaviors: A national longitudinal survey study of United States veterans with a recent suicide attempt

BackgroundThis study reports on gender differences in psychosocial symptoms and suicidal thoughts and behaviors from the first longitudinal, national survey of veterans with a recent nonfatal suicide attempt to inform women-tailored suicide prevention. MethodsWe recruited all female veterans with a documented nonfatal suicide attempt between October 2018 and September 2019 and a stratified matched sample of males. Surveys were administered at baseline, month 6, and month 12; 968 veterans completed the baseline survey with valid gender data. Surveys assessed psychosocial constructs, suicidal ideation severity, and suicidal behavior. Administrative datasets provided healthcare and suicide attempt data during the one year follow up. ResultsWomen retained higher social rejection and institutional betrayal, and lower self-compassion and autonomy than men over follow up. Higher overall self-compassion was associated with lower baseline suicide ideation for both women and men; however, this association was stronger for women (Δ = −0.19; 95 % CI = -0.31, −0.07; d = −0.15). Individuals with higher overall psychological distress had greater odds of a subsequent suicide attempt (AOR = 2.20, 95 % CI = 1.56, 3.11). Social rejection had the strongest association with worsening psychological distress, both within individuals (b = 0.18; 95 % CI = 0.14, 0.23; d = 0.23) and between individuals (b = 0.07; 95 % CI = 0.04, 0.10; d = 0.09). LimitationsResults may not generalize beyond a VHA-utilizing veteran population. ConclusionsFindings from this study inform potential therapeutic targets and topics for future research on tailoring suicide prevention for women veterans. While all veterans may need support reducing distress, women may need additional support in multiple other areas.

Suicidal Behavior of Australian Males, From an Ethnicity Perspective

Background Suicide is the 10th leading cause of death among Australian males. Despite the cultural diversity in Australia, there is a significant research gap in knowledge of suicidal behavior among Australian males from ethnically and culturally diverse backgrounds. The study aimed to estimate the prevalence and risk of suicidal behaviors among Australian males based on ethnicity, with an emphasis on those from ethnic-minority backgrounds. Methods We used data from the first wave of the Australian Longitudinal Study on Male Health. Multiple logistic regression models were used to determine the risk of suicidal behavior (lifetime suicide attempt, lifetime suicidal ideation, recent suicidal ideation) by ethnicity. Results Among ethnic minority males, Pacific Islander males also had the highest prevalence of lifetime suicide attempts (12.2%), while Middle Eastern (2.3%) and South-/North-East Asian males (2.9%) had the lowest rates. South American males had the highest recent suicidal ideation (18.2%), followed by Pacific Islanders (14.2%). The highest prevalence of lifetime suicidal thoughts was reported among males of mixed ethnicity (23.0%), followed by South American (14.6%) and Pacific Islander (13.5%) males. Most ethnic-minority groups had a lower risk of lifetime suicidal ideation compared with Australian males. Evidence regarding differences in recent suicidal ideation and lifetime suicide attempts between ethnic-minority and Australian-background males was inconclusive. Conclusion Evidence was found of differences in suicidal behaviors among Australian males based on ethnicity. Future research should use inclusive methodologies to confirm these associations and explore the underlying factors contributing to higher rates of suicidal behavior in specific populations.

Are visual analogue scales valid instruments to measure psychological pain in psychiatric patients?

ObjectiveThe Psychological-Physical-Pain Visual Analogue Scale (PPP-VAS) was thought to probably help in identifying patients at risk of suicide. However, no data on its validity to measure psychological pain was available. Our main aim was to investigate the convergent validity of the PPP-VAS using two well-validated scales of psychological pain, the Orbach and Mikulincer Mental Pain scale (OMMP) and the Holden et al. Psychache Scale. MethodsThis multicentre study recruited a total of 1618 adult psychiatric inpatients and outpatients in Italy. Psychological pain was evaluated using the OMMP, Holden et al., and PPP-VAS scales. Psychiatric status, suicidal status, physical pain, depression, and hopelessness were also assessed. ResultsA structural equation model (SEM) using the items of psychological pain from the PPP-VAS showed that items loaded significantly on the psychological pain factor and showed good fit. Similarly, a second SEM model using the three scales of psychological pain showed acceptable fit and converged into a psychological pain construct. Correlations between the PPP-VAS and depression, hopelessness, and physical pain showed moderate correlations (r = 0.43 to r = 0.67). Finally, psychological pain evaluated with the PPP-VAS was significantly related with recent suicidal ideation in all patients (OR [95 % CI] = 1.07 [1.05, 1.09]) and recent suicide attempts in moderately to severely depressed patients, OR [95 % CI] = 1.01 [1.02, 1.03]. ConclusionThe PPP-VAS showed good psychometric properties in evaluating psychological pain. The characteristics of the PPP-VAS makes this scale a great option for its use in clinical practice to detect patients at risk of suicide.

Characteristics of recently incarcerated primary care patients with and without a positive posttraumatic stress disorder screening upon clinic intake.

Posttraumatic stress disorder (PTSD) is prevalent among people who have been incarcerated. Here, we examined whether screening positive for PTSD was associated with other indicators of poor health, acute healthcare utilization, and poverty among primary care patients upon release from incarceration. We conducted a cross-sectional survey in a national network of primary care clinics serving people recently released from incarceration. Participants were 416 patients who completed the Primary Care PTSD screen (PC-PTSD) and other questions about mental and physical health, acute healthcare utilization, and economic status within 6 months of release. Screening positive for PTSD was associated with worse status across nearly all variables examined, including being more likely to report: poor/fair health (61.6% vs. 41.7%), current depressive symptoms (89.7% vs. 50.8%), lifetime depression diagnosis (63.3% vs. 35.3%), cannabis use since release (20.7% vs. 9.6%), homelessness (31.9% vs. 18.5%), having no cash on hand (56.3% vs. 39.0%) and severe food insecurity (29.3% vs. 18.2%; all ps < .01). Reporting recent suicidality (14.3% vs. 7.0%), alcohol use since release (30.2% vs. 20.0%), and emergency department utilization (20.4% vs. 12.2%) was also more likely (all ps ≤ .03). These trends were largely upheld when controlling for demographic characteristics and chronic physical health conditions using linear probability regression. Primary care patients recently released from incarceration have a need for wrap-around services that address health challenges and poverty. Patients with significant PTSD symptoms face even greater challenges. Identification and treatment of PTSD both during and after incarceration is warranted. (PsycInfo Database Record (c) 2024 APA, all rights reserved).