Significant Predictors Of Suicide Attempts Research Articles

A Study to Assess the Prevalence of Non-suicidal Self Injury and Reasons for that Behaviour among Adults and their Coping

Introduction: Non-Suicidal self-injury (NSSI) is both highly comorbid with suicidality among
 adolescents and a significant predictor of suicide attempts (SAs) in adolescents.A broad variety of different functions can underlie acts of Non-suicidal self-injury (NSSI).
 Aims: To study prevalence and characteristics of Non-suicidal self-injury (NSSI) and functional purpose of that behaviour among Adults and their level of coping.
 Study Design: Cross-sectional Analytical study.
 Place and Duration of Study: The study is conducted in central medical university, Gujarat, India over a period of 30 days.
 Methodology: Study was conducted among students of Central Medical University.195 participants were enrolled by consecutive random sampling. They were given a Google form to fill out Demographic details. The form also has an Inventory for NSSI (ISAS) to assess their NSSI behaviour and Brief Resilient Coping Scale (BRCS) to assess coping.
 Results: Out of 195 participants, prevalence of NSSI behaviour is 49(25.12%). Among these 20(40.82%) are male & 29(59.18%) are female. Among sociodemographic data type of family is statistically significant(P value- 0.039). Mean age at which participants start self-harming is16.6 ± 2.89 years. During NSSI behaviour 51.02% of participants always feel pain and 16.32% of participants do not feel pain. Prevalence of NSSI behaviour is higher in 3rd or higher birth order (33.33%) compare to 1st(28.31%) and 2nd (19.67%).The most common method of self-harm was cutting (65.3%), followed by banging (61.22%) or hitting self. The most common functional reason for self-harm was affect regulation followed by self-punishment. of participants who are having NSSI behaviour. In this study we found that there is a statistically significant difference between various resilience coping and NSSI behavior.(P- 0.0008).
 Conclusion: The most common method of self-harm is cutting and functional purpose for this behavior is affect regulation. Individual with low resilient coping have higher chances of NSSI behavior and similarly high resilient coping is protective for NSSI behavior.

Adverse Childhood Experiences and Suicidality and Self-Harm in Persons in Secure Forensic Care.

Prior research suggests a greater degree of suicidality and self-harm behavior in those involved with criminal justice and forensic mental health systems. Such individuals also evidence increased exposure to early childhood adversity, which is often associated with suicide risk. Other significant predictors of suicidality have been noted within forensic populations, however, including indicators of specific psychopathology and situational and demographic factors. These populations present with overlapping risk factors that remain underexamined. In the current study, 182 persons residing in secure forensic psychiatric care following incidents of illegal and aggressive behavior were evaluated. Adverse childhood experiences and other empirically derived potential predictors of suicide attempts and self-harm were examined via binomial logistic regression. Findings indicate frequent experiences of early adversity across participants, and that a combination of race, individual adverse childhood experiences, number of biological children, and diagnoses of either posttraumatic stress disorder or borderline personality disorder were significant predictors of suicide attempts, self-harm behavior, and first hospitalization resulting from a suicide attempt. Clinical and research implications are discussed.

Comparison of the factors for suicidal ideation and suicide attempt: a comprehensive examination of stress, view of life, mental health, and alcohol use.

This study was performed to examine the elements that cause suicidal ideation to develop into a suicide attempt by comparing the factors related to suicidal ideation and attempt. The subjects in the study were 5982 employees, who received mental health screening from January 2016 to December 2019 in Korea. Multivariate binary logistic regression analysis was performed with suicidal ideation and suicide attempt as dependent variables respectively. While suicidal ideation was associated with both moderate and severe grades of depression and alcohol consumption, only severe grades of depression and alcohol consumption were associated with suicide attempts. Among family, interpersonal, work-related, and financial stress, which were significant predictors of suicidal ideation, only family stress predicted suicide attempts. Whereas dissatisfaction with the present, regret for the past, and hopelessness for the future were all predictors for suicidal ideation, only regret for the past was a significant predictor of suicide attempts. The distinctive impact of family stress on suicide attempts suggests that family support can play a pivotal role in suicide prevention, and the significant impact of regret for the past on suicide attempts indicates the need for a cognitive approach ina high-risk population. Finally, the substantial impact of alcohol on suicide attempts compared to suicidal ideation suggests the importance of alcohol regulation in suicide prevention.

Self-harm and suicidality among three subgroups of male sex offenders: results from an Australian prisoner cohort

ObjectivePrisoners complete suicide and self-harm more frequently than members of the community. Sex offenders have been found to be at greater risk of engaging in these behaviours. This study examines the characteristics, prevalence, and predictors of self-harm and suicide attempts among: sex offenders that only victimise children (ChildSOs); adults (AdultSOs); or both (age-crossover polymorphous; PolySOs).MethodsData from three waves (1996, 2001, 2009) of the New South Wales (NSW) Inmate Health Survey was linked to the State’s re-offending database to identify men with histories of sexual offending. The health surveys captured self-report data on self-harm and suicidality.ResultsNon-sexual violent offenders (15%) and AdultSOs (14%) had the highest rate of self-harm, significantly more than ChildSOs (11%), non-sexual non-violent offenders (10%), and PolySOs (0%). Several factors significantly predicted self-harm at the bivariate level for both ChildSOs and AdultSOs, with unique predictors for each group. At the multivariate level, manic-depression trended towards significance for ChildSOs and any mental health condition remained a significant predictor for AdultSOs who self-harmed relative to AdultSOs who had not (aOR = 11.989, 95%CI [1.14, 126.66]). Approximately 23% of AdultSOs, 22% of PolySOs, and 19% of ChildSOs reported a suicide attempt throughout their lifetime, whereas only 15% of non-sexual non-violent offenders reported an attempt. At the bivariate level, few factors were significant for ChildSOs while several factors were significant for AdultSOs. At the multivariate level, a diagnosis of depression and treatment with psychiatric medication trended towards being significant predictors of suicide attempts for ChildSOs. In contrast, treatment with psychiatric medication (aOR = 25.732, 95%CI [1.91, 347.19])] remained a significant predictor for AdultSOs who attempted suicide relative to AdultSOs who had not, as well as historical psychiatric hospitalisation (aOR = 6.818, 95%CI [1.04, 44.82]) and self-harm (aOR = 5.825, 95%CI [1.31, 25.99]).ConclusionSex offenders are at significantly higher risk of attempting and completing suicide relative to non-sexual non-violent offenders and warrant special attention. The prevalence rates and predictors of self-harm and suicidality suggest differences between sex offender subgroups may exist. These hold implications for the criminal justice and public health systems for addressing needs and identifying those most at risk of self-harm and suicide.

Risk factors for suicide attempt in children, adolescents, and young adults hospitalized for mental health disorders.

Suicide is a leading cause of death among children, adolescents, and young adults (AYA), and mental health disorders are a major contributing factor. Yet, suicidal behaviors among children and AYA with mental health concerns remain understudied and age-specific risk factors are poorly understood. We examined the risk factors for suicide attempt in children and AYA with mental health disorders across three age groups: pre-adolescent children (aged≤12), adolescents (aged 13-17), and young adults (aged 18-25). A cross-sectional study of children and AYA hospitalized for a mental health disorder (n=18,018) at a private hospital system with 141 facilities across the United States (year 2014). Suicide attempts six months prior to hospitalization were reported in 12.1% (n=177) pre-adolescent children, 22% (n=1476) adolescents, and 17.9% (n=1766) young adults. Evidence of psychological trauma was present in 55.4% of pre-adolescent children, 51.2% of adolescents, and 44.5% of young adults. Predictors for suicide attempt observed across all three age groups included the following: female sex, depressive disorder, and being a victim of bullying. Risk factors for suicide attempt specific to pre-adolescent children included being uninsured and having an unsafe home or school environment. Among AYA, suicide attempt was associated with non-Hispanic white, family history of suicide, emotional traumas, and other traumatic experiences. Alcohol use disorder was also a significant predictor of suicide attempt in young adults. Suicide attempts among children and AYA admitted to a hospital with mental health concerns are highly prevalent. Socioeconomic stressors appeared to be an important contributing factor of suicidal behavior in pre-adolescent children but not in older AYA. Effective suicide prevention strategies targeting children and AYA would need to consider age-specific risk factors.

The Effects of Depression, Anxiety, and Parents’ Support on Suicide Ideation and Attempts by Gender among Korean Adolescents

The purpose of the study was to compare factors influencing gender-related adolescent suicide ideation and attempts, focusing on depression and anxiety levels, and parental support. Data from the 2013 Korea Children and Youth Mental Health Promotion Study collected by the National Youth Policy Institute were analyzed using logistic regression. The study sample included 6316 middle and high school students. Among both male and female adolescents, the more severe the depression and anxiety of a given group (mild, moderate, severe), the higher the proportion of suicide ideation and attempts in the group with low parental support. For male adolescents, significant predictors of suicide ideation were all levels of depression, mild anxiety, and parental emotional support, whereas a significant predictor of suicide attempts was severe anxiety. For female adolescents, significant predictors of suicide ideation were all levels of depression and anxiety, as well as parental emotional and informational support. Significant predictors of suicide attempts were severe depression, moderate and severe anxiety, and parental emotional and economic support. The results can be used to improve suicide screening for high-risk adolescents. The development of mental health and parental support as part of adolescent suicide prevention programs requires different approaches for each gender.

Recent advances in understanding and managing self-harm in adolescents.

Adolescent suicide is a serious public health problem, and non-suicidal self-injury (NSSI) is both highly comorbid with suicidality among adolescents and a significant predictor of suicide attempts (SAs) in adolescents. We will clarify extant definitions related to suicidality and NSSI and the important similarities and differences between these constructs. We will also review several significant risk factors for suicidality, evidence-based and evidence-informed safety management strategies, and evidence-based treatment for adolescent self-harming behaviors. Currently, dialectical behavior therapy (DBT) for adolescents is the first and only treatment meeting the threshold of a well-established treatment for self-harming adolescents at high risk for suicide. Areas in need of future study include processes underlying the association between NSSI and SAs, clarification of warning signs and risk factors that are both sensitive and specific enough to accurately predict who is at imminent risk for suicide, and further efforts to sustain the effects of DBT post-treatment. DBT is a time- and labor-intensive treatment that requires extensive training for therapists and a significant time commitment for families (generally 6 months). It will therefore be helpful to assess whether other less-intensive treatment options can be established as evidence-based treatment for suicidal adolescents.

Self-harm as a predisposition for suicide attempts: A study of adolescents' deliberate self-harm, suicidal ideation, and suicide attempts

The aim of this study was to analyze the predictive risk factors for self-harm in adolescents with and without suicidal ideation. 600 adolescents answered a questionnaire about self-harm and suicidal behaviors. A logistic regression analysis was conducted. Over half of the individuals with deliberate self-harm (DSH) presented significant suicide risk. There was a direct association between DSH and suicide attempts, with almost the totality of the adolescents with suicide attempts also reporting DSH. According to the prediction model, suicidal ideation and diversity of DSH behaviors are significant predictors of suicide attempts, with an augmentation in the diversity of DSH behaviors and suicidal ideation predicting suicide attempts. Depression and anxiety appeared also as significant predictors of suicide attempts in adolescent self-harmers. Considering that the majority of the sample was not from a clinical setting, an alarming finding was that one third of the total sample was at suicide risk. These results place DSH as a key variable for early intervention.

186. Longitudinal Decreases in Suicidal Ideation are Associated With Increases in Salience Network Coherence in Depressed Adolescents

Suicidal ideation (SI) is a significant predictor of suicide attempt; SI itself, however, is difficult to predict. Given that SI begins in adolescence when brain networks are maturing, it is important to understand associations between longitudinal changes in network functioning and changes in severity of SI.

Alcohol and marijuana use as daily predictors of suicide ideation and attempts among adolescents prior to psychiatric hospitalization

ObjectiveLittle research has been conducted on alcohol use, marijuana use, and suicide ideation and attempts on a daily level, and specifically among adolescents prior to inpatient hospitalization. The purpose of this study was to examine the within (over time) and between (between adolescents) effects of alcohol use and marijuana use on suicide ideation and attempts. MethodsParticipants included 50 adolescents (80% female; Mage = 15.8). All participants reported drinking alcohol in the prior three months and were receiving treatment in an inpatient psychiatric hospital. Random and mixed-effect models were used to test study hypotheses. ResultsResults from the random effect model indicated that alcohol use, marijuana use, hospitalization and sexual orientation were significant predictors of suicide attempts. Results from the mixed-effect model indicated that marijuana use, hospitalization, and sexual orientation were significant predictors of suicide ideation. ConclusionsStudy findings extend current knowledge about the longitudinal and day-to-day relationship between alcohol and marijuana use and suicide ideation and attempts. Results underscore the importance of addressing alcohol and marijuana use in interventions with suicidal adolescents, recognizing that sexual minority youth may be at elevated risk for suicide ideation.

Predictors of Lifetime Suicide Attempts in Individuals With Attenuated Psychosis Syndrome

A strong association has been shown to exist between schizophrenia and suicide; however, research examining suicidality in the prodromal phase of psychotic disorders is limited. This study aimed to meet this need by examining potential risk factors for lifetime suicide attempts in a population of individuals with attenuated psychosis syndrome (APS), as defined in the fifth edition of the Diagnostic and Statistical Manual for Mental Disorders as a condition for further study. A retrospective chart review was conducted to identify individuals with APS during a 5-year period across a large medical university's inpatient and outpatient settings. Sociodemographic and clinical factors were examined in relation to suicide attempts to identify risk factors for suicide attempts. χ analyses were used to analyze dichotomous variables, and t test analyses were used to compare means of continuous predictors among those with versus without suicide attempts. Final analyses consisted of fitting multivariate logistic regression models to control for sociodemographic factors. In total, 26.3% of the APS population had at least 1 lifetime suicide attempt. Six covariates were found to be statistically significant predictors of suicide attempts: Axis II disorders (P=0.006); history of trauma as a whole (P=0.022); the subcategory of sexual trauma (P=0.005); tobacco use (P=0.039); family history of nonpsychotic Axis I disorders (P=0.042); and number of hospitalizations (P=0.001). Suicidality is a prominent feature of APS, and a number of risk factors increase the likelihood of suicide attempts in this population.

Ethnic Variations of Trajectories in Suicide Ideation and Attempt: From Middle School to High School

The purpose of this study was to compare patterns of suicide ideation and suicide attempt in three ethnic groups. We analyzed data from 463 students with ethnic backgrounds of African American (AA), Asian American (ASA), and European American (EA) for 6years. The best fit model was a three-trajectory class model for all groups. The majority of adolescents belonged in the nonideators trajectory. The high level of ideation was found in the high ideators (4%), high-fluctuating ideators (8%), and high-decreasing ideators (4%) trajectory in AA, ASA, and EA, respectively. In the AA group, being a member of ideators was not a significant predictor of suicide attempt. In the ASA group, being a member of high-fluctuating ideators was a significant predictor. In the EA group, being a member of both ideators predicted suicide attempt. The timing of onset, patterns of change, and peak time in the ideators trajectories in the three ethnic groups were markedly different. The high level of attempts found in the ASA-AA group was not explained by having suicide ideation. Findings suggest the need for in-depth examination of suicide behaviors across ethnic groups and culturally adapted preventive efforts with distinct developmental timing for adolescents from different ethnic backgrounds.

Moral injury, posttraumatic stress disorder, and suicidal behavior among National Guard personnel.

To empirically examine similarities and differences in the signs and symptoms of posttraumatic stress disorder (PTSD) and moral injury and to determine if the combination of these 2 constructs is associated with increased risk for suicidal thoughts and behaviors in a sample of U.S. National Guard personnel. 930 National Guard personnel from the states of Utah and Idaho completed an anonymous online survey. Exploratory structural equation modeling (ESEM) was used to test a measurement model of PTSD and moral injury. A structural model was next constructed to test the interactive effects of PTSD and moral injury on history of suicide ideation and attempts. Results of the ESEM confirmed that PTSD and moral injury were distinct constructs characterized by unique symptoms, although depressed mood loaded onto both PTSD and moral injury. The interaction of PTSD and moral injury was associated with significantly increased risk for suicide ideation and attempts. A sensitivity analysis indicated the interaction remained a statistically significant predictor of suicide attempt even among the subgroup of participants with a history of suicide ideation. PTSD and moral injury represent separate constructs with unique signs and symptoms. The combination of PTSD and moral injury confers increased risk for suicidal thoughts and behaviors, and differentiates between military personnel who have attempted suicide and those who have only thought about suicide. (PsycINFO Database Record

Predictors of Suicide Attempts in Clinically Depressed Korean Adolescents.

We examined predictors of suicide attempts in clinically depressed adolescents in Korea and gender differences in suicidal behavior. In total, 106 adolescents diagnosed with depressive disorder were recruited in South Korea. We assessed various variables that might affect suicide attempts, and used a structured interview for the diagnosis of depression and comorbidities and to evaluate suicidality. Demographic and clinical characteristics of the subjects were compared between suicide attempt and non-suicide attempt groups and we examined significant predictors of suicide attempts. Gender differences in suicidal ideation and suicidal behavior were also analyzed. Among 106 depressed participants, 50 (47.2%) adolescents were classified in the suicide attempt group. Generally, the suicide attempt and non-suicide attempt group shared similar clinical characteristics. The suicide attempt group had more females, more major depressive disorder diagnoses, more depressive episodes, and higher suicidal ideation than the non-suicide attempt group. Suicidal ideation was the only significant predictor of suicidal attempt, regardless of gender. Higher suicidal ideation frequency scores and more non-suicidal self-injurious behaviors were shown in the female suicide attempt group than the male suicide attempt group. It is recommended that suicidal ideation be assessed regularly and managed rigorously to decrease suicide risks in depressive adolescents.

A 12-Month prospective study of the effects of PTSD-depression comorbidity on suicidal behavior in Iraq/Afghanistan-era veterans

The present study used validated clinical interviews to assess the effect of comorbid PTSD-depression on suicidal behavior over the course of 12 months in 309 Iraq/Afghanistan-era veterans. Logistic regression models demonstrated that comorbid PTSD-depression was a statistically significant predictor of suicide attempts at the 12-month follow-up in both the total sample and in the subset of veterans with PTSD/depression (n=98). In contrast, gender, age, race, sexual orientation, and baseline history of suicide attempts did not have significant effects. These findings suggest that comorbid PTSD-depression may be a significant risk factor for future suicidal behavior in veterans.

The Role of Sleep Disturbance in Suicidal and Nonsuicidal Self-Injurious Behavior among Adolescents.

The relationship between different sleep disturbances and self-harm thoughts and behaviors was examined among 223 adolescents presenting to a community clinic for mood disorders and suicidal and nonsuicidal self-injurious behaviors. Two-thirds of the adolescents reported nightly, severe sleep complaints. Relative to adolescents without significant sleep complaints, patients with severe sleep complaints at the time of clinic entry endorsed significantly more engagement in nonsuicidal self-injury. Middle insomnia and circadian reversal were both significant predictors of suicide attempts. Terminal insomnia was significantly associated with suicidal ideation. Results support the importance of assessing sleep difficulties among adolescents at risk for suicide.

The association of adverse childhood experiences and appetitive aggression with suicide attempts and violent crimes in male forensic psychiatry inpatients

Although previous studies in inmates, forensic and psychiatric samples suggest the relation between childhood trauma and suicide behavior as well as between childhood trauma and violent delinquency, the understanding of possible underlying mechanisms is still fragmentary. In a naturalistic study design, we tested if suicidal attempts and violent crimes are differently associated with adverse childhood experiences and levels of appetitive aggression in male forensic psychiatry inpatients. Adverse childhood experiences and appetitive aggression styles were collected by means of self-report measures, suicide attempts were taken from the medical history and violent crimes were appraised by official court records. The data were analyzed by the means of generalized linear models. Results revealed that appetitive aggression and adverse childhood experiences were significant predictors of suicide attempts, whereas violent crimes were associated solely with appetitive aggression. Suicide attempts and violent delinquency in forensic patients seem to be both positively associated with high levels of appetitive aggression, whereas their etiological pathways might differ with regard to adverse childhood experiences. Considering these interrelations to a greater extent might improve both diagnostics and treatment of forensic patients.

History of sexual abuse and suicide attempts in alcohol-dependent patients

History of child abuse is considered one of the important risk factors of suicide attempt in general population. At the same time it has been shown that suicide attempts appear significantly more frequently in alcoholics than in healthy individuals. The objective of this study was to investigate associations between history of childhood sexual abuse and suicide attempts in a sample of Polish alcohol dependent patients. A sample of 364 alcohol-dependent subjects was recruited in alcohol treatment centers in Warsaw, Poland. Information was obtained about demographics, family history of psychiatric problems, history of suicide attempts, sexual and physical abuse during childhood and adulthood and severity of alcohol problems. When analyzed by gender, 7.4% of male and 39.2% of female patients had a lifetime history of sexual abuse; 31.9% of the study group reported at least one suicide attempt during their lifetime. Patients who reported suicide attempts were significantly younger (p=0.0008), had greater severity of alcohol dependence (p=0.0002), lower social support (p=0.003), and worse economic status (p=0.002). Moreover, there was a significant association between history of suicide attempts and family history of psychiatric problems (p=0.00025), suicide attempts in the family (p=0.0073), childhood history of sexual abuse (p=0.009) as well as childhood history of physical abuse (p=0.002). When entered into linear regression analysis with other dependent variables history of childhood sexual abuse remained a significant predictor of suicide attempt (OR=2.52; p=0.035). Lifetime experience of sexual abuse is a significant and independent risk factor of suicide attempts in alcohol-dependent individuals.

Attempted Suicide in a Xhosa Schizophrenia and Schizoaffective Disorder Population

Suicide risk behavior is a significant contributor to the mortality and morbidity of schizophrenia. We previously reported affected sibship status in a Xhosa schizophrenia or schizoaffective disorder sample to be protective in nature; given the counterintuitive nature of this finding, we expanded the sample size to seek further clarification. Subjects were assessed with the Diagnostic Interview for Genetic Studies and then stratified into two groups: with (n = 137) or without (n = 837) a previous suicide attempt. The presence of lifetime bizarre behavior (OR 1.5; 95% CI 1.12-1.87) or cannabis use or abuse (OR 1.2; 95% CI 10.01-1.47) was a significant predictor of suicide attempts, while a higher global alogia score (OR 0.84; 95% CI 0.74-0.96) was a protective factor. Our data seem to support that in this population, encouraging family members to report bizarre behavior and implementing dual diagnosis interventions for cannabis use or abuse could be an appropriate starting point toward developing a targeted suicide prevention program for further research.

The Mediating Roles of Stress and Maladaptive Behaviors on Self-Harm and Suicide Attempts Among Runaway and Homeless Youth

Runaway and homeless youth often have a constellation of background behavioral, emotional, and familial problems that contribute to stress and maladaptive behaviors, which, in turn, can lead to self-harming and suicidal behaviors. The current study examined the roles of stress and maladaptive behaviors as mediators between demographic and psychosocial background characteristics and self-injurious outcomes through the lens of the stress process paradigm. The model was tested in a sample of runaway and homeless youth from Los Angeles County (N=474, age 12-24, 41% female, 17% White, 32.5% African American, 21.5% Hispanic/Latino). Background variables (gender, age, sexual minority status, parental drug use history, and emotional distress) predicted hypothesized mediators of maladaptive behaviors and recent stress. In turn, it was hypothesized that the mediators would predict self-harming behaviors and suicide attempts in the last 3months. Females and LGBT (lesbian, gay, bisexual, transgender) youth were more likely to have self-harmed and attempted suicide; younger participants reported more self-harming. The mediating constructs were associated more highly with self-harming than suicide attempts bivariately, although differences were modest. Maladaptive behaviors and recent stress were significant predictors of self-harm, whereas only recent stress was a significant predictor of suicide attempts. All background factors were significant predictors of recent stress. Older age, a history of parental drug use, and greater emotional distress predicted problem drug use. Males, younger participants, and participants with emotional distress reported more delinquent behaviors. Significant indirect effects on self-harming behaviors were mediated through stress and maladaptive behaviors. The hypothesized paradigm was useful in explaining the associations among background factors and self-injurious outcomes and the influence of mediating factors on these associations.