Likelihood Of Suicide Research Articles

The association between childhood adversity and perinatal suicidality

Suicide is a leading contributor of maternal mortality, however identification of individuals at risk is challenging. Adverse childhood experiences (ACEs) are associated with negative health outcomes in adulthood in the general population, including suicide attempts. Our objective was to determine whether ACEs are associated with suicidality in the perinatal period. This cohort study included pregnant and postpartum people who enrolled in a collaborative care model (CCM) for mental health support between 2017-2021. At enrollment, participants completed an ACE screen; a high ACE score was defined as > 3. CCM participants were followed from enrollment until up to 12 months postpartum with serial depression screens, including self-reported assessments of suicidal ideation. For these analyses, reported suicidal ideation within any completed assessment was considered representative of perinatal suicidality. The relationship between a high ACE score and perinatal suicidality was assessed. Other exposures evaluated included ACE screen score as an ordinal variable and categories of reported ACEs (i.e., abuse, neglect, and household challenges). A propensity score was used in multivariable models to control for covariates that significantly differed by ACE screen score. Of the 1,767 pregnant or postpartum people enrolled in the CCM with a completed ACE screen, 333 (19%) reported a high ACE score and 299 (13%) endorsed suicidality. Those with a high ACE screen score had an increased likelihood of suicidality (33.6% vs 12.9%, p< 0.001). The ACE screen score had a graded association with suicidality (p< 0.001; Table 1). Subcategories of ACEs were each associated with an increased odds of suicidality, however no meaningful differences in the odds of suicidality were observed across ACE categories (Table 2). Within a population of individuals enrolled in a perinatal CCM for mental health care, childhood adversity is associated with suicidality with a dose-response relationship. Screening for ACEs may represent an opportunity to identify individuals at risk for perinatal suicide.View Large Image Figure ViewerDownload Hi-res image Download (PPT)

Investigation of the Relationship Between Suicide Probability and Distress Tolerance in Obsessive Compulsive Disorder

The risk of suicide is higher in obsessive-compulsive disorder (OCD) than in the general population. There are several risk factors associated with suicidality in OCD. Distress tolerance is the capacity to experience and withstand negative psychological states. The aim of this study was to investigate the relationship between distress tolerance and suicidality in OCD. This study was conducted on 83 patients diagnosed with OCD. OCD-related data were obtained with the Yale Brown Obsession Compulsion Scale (YBOCS) and the Dimensional Obsession Compulsion Scale (DOCS). Suicide Probability Scale (SPS) was used to assess suicide risk. Distress Tolerance Scale (DTS) was used to measure the level of distress tolerance. Severity of anxiety and depression symptoms was assessed with the Beck Anxiety Inventory (BAI) and Beck Depression Inventory (BDI). The proportion of patients with a history of attempted suicide at any point in their lives was 13.3%. As a result of the regression analysis, DTS score, YBOCS score, BDI score, history of suicide attempt, and having a diagnosis of any personality disorder were associated with SPS score. Decreased DT capacity was associated with increased suicide probability. Distress tolerance capacity is a predictive factor for suicide probability in OCD. Suicidality in OCD is an important clinical entity that requires attention. Close monitoring of patients with risk factors that increase the likelihood of suicide may provide an opportunity for early intervention. Psychological interventions aimed at increasing DT capacity may be useful in reducing the suicide probability.

THE IMPACTS OF DEPRESSION AND SUICIDE ATTEMPTS AMONG OLDER MEN WHO HAVE SEX WITH MEN

Abstract Suicidality among older adults has attracted much attention due to their vulnerability. Older men who have sex with men (OMSM) have rarely been studied psychologically. Study examines factors that affect the mental health of OMSM, including depression, suicidal tendency, and suicide likelihood. OMSM in the United States are analyzed using descriptive statistics for correlations between depression and suicidal tendency. A literature review helped us select scales based on the regression model we constructed. Control variables were assessed for validity and relevance. A dependent variable was depression, and a dependent variable was suicidal tendencies. Depression and suicidal tendency scores significantly differed between men who have sex with men and the general population (t = 67.084,58.193, P &amp;lt; 0.01). Suicidal tendencies and depression are significantly higher among homosexuals than among general groups. The regression analysis shows older men who have sex with men are more likely to suffer from depression and suicide (P &amp;lt; 0.01). Depression and suicide rates in OMSM are higher than those in the general population. The level of depression, in the intermediary test, mediates both the effect of OMSM on individual suicidal tendency and individual suicidal behavior (P &amp;lt; 0.01). Suicidal tendencies in OMSM can be reduced through depression intervention.

Hope As a Buffer to Suicide Attempts Among Adolescents with Depression.

Suicide among adolescents has long been linked to symptoms of depression. However, limited research has examined the potential buffering effect of hope on the relationship between depression and suicide attempts. To test the effect of hope on the positive relationship between depression and suicide attempts, we used data (N=502 adolescents) from youth ages 12-18 collected as part of the 2018 Healthy Youth Survey in the State of Washington. Based on hope theory, we hypothesized a "buffering" form of moderation, with the presence of greater hope weakening the positive relationship between depression and suicide attempts. In other words, with higher hope, adolescents reporting depressive symptoms are less inclined to attempt suicide. Testing the moderating effect of hope via bootstrap resampling (N=5000), the results indicated adolescents' hope levels indeed buffered the relationship between depressive symptoms and self-reported suicide attempts. To wit, when adolescents' hope was low, there was a significant, robust, and positive relationship between depressive symptoms and suicide attempts (b=0.2644, 95% CI [0.1604, 0.3683], t=5.0, p < .001). However, when adolescents' hope was high, there was no longer a significant relationship between depressive symptoms and suicide attempts (b=0.0304, 95% CI [-0.997, 0.1605], t=0.4590, p=.65). The buffering effect of hope was validated in a second, larger sample (n=9308) of adolescents. This result suggests the potential utility of hope theory-based interventions to assist depressed adolescents reduce their likelihood of suicide.

Health Diagnoses and Service Utilization in the Year Before Youth and Young Adult Suicide.

Suicide rates among young people are rising. Health care visits provide opportunities for identification and intervention, yet studies have been limited by small or circumscribed samples. This study sought to expand the knowledge base by examining health care encounters and diagnoses among young people who later died by suicide. This case-control study examined diagnoses of mental and general medical disorders and health care utilization in the 30 and 365 days before suicide death in nine large U.S. health care systems. Data (years 2000-2015) from 445 suicide decedents ages 10-24 years were matched with data from 4,450 control group patients. Suicide decedents were more likely to have at least one mental disorder diagnosis (51% vs. 16%; adjusted OR [AOR]=5.74, 95% CI=4.60-7.18) and had higher rates of nearly all mental health conditions. Substance use disorders were common (12%) and more likely (AOR=8.50, 95% CI=5.53-13.06) among suicide decedents. More than one in three (42%) suicide decedents had a health care visit in the month before death, and nearly all (88%) had a visit in the previous year. Despite the greater likelihood of suicide associated with mental disorder diagnoses, such disorders were present among only 51% of suicide decedents. High rates of health care utilization among suicide decedents indicate a need for improving identification of mental health conditions and suicide risk across the health care system. Increased substance use screening may help identify youths at high risk because substance use disorders were significantly more prevalent and likely among suicide decedents.

Moderating role of coping in the association between minority stress and suicidal ideation and suicide attempts among sexual and gender minority young adults.

This study examined associations of minority stressors (i.e., victimization, internalized homonegativity, and stigma consciousness), and coping styles (i.e., active, avoidant, and passive) with suicidal ideation and suicide attempts (suicidality) among sexual and gender minority (SGM) young adults, and whether coping style moderated these associations. Logistic regression analyses examined these associations among 1432 SGM young adults (ages 18-29). Minority stressors and passive coping were associated with a higher likelihood of suicidality. Avoidant coping was associated with a lower likelihood of lifetime suicidal ideation and attempts among sexual minority participants, and active coping with a lower likelihood of past-year suicidal ideation among sexual minority participants. Moderation analyses among sexual minority participants showed that when avoidant coping was high, associations between low victimization (compared with no victimization) and lifetime suicide attempts, and stigma consciousness and lifetime suicide attempts became non-significant, and the association between internalized homonegativity and lifetime suicide attempts became significant. Among gender minority participants, when passive coping was high the association between low victimization and lifetime suicidal ideation became significant. This study underlines the importance of minority stress and coping for suicidality among SGM young adults and the need for more research regarding the role of coping.

The association between sleep and suicidality in the presence and absence of depressive symptoms: A cross-sectional study in rural China.

This study aimed to explore the association between sleep and suicidality in the presence and absence of depressive symptoms in the rural Chinese population. The research involved a cross-sectional survey conducted in Liuyang, China, between November 2010 and August 2011. A total of 2052 participants were surveyed (987 males and 1065 females). To investigate the mediating effect of depressive symptoms in the correlation between sleep quality and suicidality. The association between sleep quality and suicidality in the absence of depressive symptoms was also explored. Suicide risk was measured using the Mini-International Neuropsychiatric Interview subscale. The visual analog scale was used to assess sleep quality. Patient Health Questionnaire-9 and Patient Health Questionnaire-2, avoiding the overlap in sleep and suicidality assessments, were used for detecting depressive symptoms in participants. Depressive symptoms partially mediated the association between sleep quality and suicidality among rural adults. Furthermore, some participants did not exhibit depressive symptoms in this study yet still exhibited a risk for suicidality, with poor sleep quality contributing significantly to their suicidality even after adjusting for cofounders. Poor sleep quality significantly increases the likelihood of suicidality in the presence and absence of depressive symptoms in the rural Chinese population. Poor sleep quality could correlate with increased suicide risk independently of depressive symptoms.

Suicide among Older People in Different European Welfare Regimes: Does Economic (in)Security Have Implications for Suicide Prevention?

Older adult suicide rates vary widely within Europe, and differential welfare policies might contribute to this. We studied variations in economic indicators and suicide rates of people 65+ across 28 European countries and examined the effects of these indicators on suicide rates, grouping countries according to their socio-political systems and welfare regimes. Suicide data was obtained from the WHO European Mortality Database. The European Union Statistics on Income and Living Conditions and the European Union Labour Force Survey provided data on economic indicators. Linear mixed models were applied. Suicide rates ranged from 4.22/100,000 (Cyprus) to 36.37/100,000 (Hungary). Material deprivation was related to elevated suicide rates in both genders in the pooled data set and in men but not women in the Continental and Island countries. Higher ratio of median income (65+/under 65) was associated with lower likelihood of suicide in women in the South-Eastern European countries. In the Nordic region, the 65+ employment rate was associated with a decreased likelihood of suicide in men. These factors to some extent show economic insecurity against older people, which influences the likelihood of suicide. Active labor market policies and inclusive social environment may contribute to suicide prevention in this age group.

The Impact of Stigma on Forensic Psychiatric Patients - a Case Report

AimsThe Royal College of Psychiatrists’ Fair Deal (RCPsych 2008) highlighted the far-reaching impact of stigma and discrimination on the lives of people with mental illness. The pervading nature of stigma has been acknowledged in recent national and international mental health policies (WHO). The World Health Organisation reiterates people affected by mental illness should not suffer social exclusion and marginalisation due to stigma.MethodsA sixty-year-old gentleman presented to the Emergency Department following self-inflicted stabbing to the neck resulting in pharyngeal tear and surgical repair. Previous psychiatric history included inpatient admission on Section 2 following a major depressive episode. On this admission, inpatient psychiatric review elicited three months of psychotropic medication non-adherence due to difficulties the patient had encountered in acquiring repeat medications from his GP. He had relapsed into alcohol misuse as a coping mechanism culminating in a suicide attempt at home with a knife. Upon recommencing of sertraline and risperidone during admission, he was assessed as euthymic with low risk to self. The patient had been previously abstinent from alcohol and described religion as a protective factor. Prior to discharge, the patient's GP stated he must present to the surgery in person with a form of identification. This is despite CQC guidance stipulating practices should not refuse patients registration if proof of identity cannot be produced.ResultsThis case illustrates the socioeconomic factors increasing likelihood of suicide including forensic history, low financial status, unstable housing and lack of social support. Substance dependence is a risk factor that can be reduced by supporting patients in accessing specialist misuse input from inpatient and community teams. The patient reported fear of stigmatisation and criminalisation which led to the avoidance of seeking treatment, deterioration in mental health and severe clinical consequences. It is imperative marginalised patients with mental illness can access quality health care and this starts with GP registration.ConclusionForensic mental health patients experience multiple stigmas impacting on well-being including social, institutional and media stigmatisation and high levels of internalised stigma. The Time to Change campaign focused on changing attitudes and behaviour however evaluation illustrated difficulties in tackling this issue. Healthcare professionals should be mindful to avoid stigmatising language and actions to ensure fairness in care. There is a need for the medical profession to continue striving for a tangible shift in attitudes. Advocating for those with mental illness can enhance quality of life for vulnerable patient groups.

Longitudinal Patterns of Suicidality Among Heroin Users in Johannesburg, South Africa: A Need for Suicide Screening and Intervention.

ObjectivesThe objective of the study was to longitudinally assess the outcomes and correlates of suicidal ideation and behavior (SIB) among heroin users who attended inpatient detoxification and psychosocial rehabilitation. SIB was assessed in 300 heroin users upon entry into inpatient detoxification (baseline) as well as 3-months (t1) (n = 252; 84%) and 9-months (t2) (n = 225; 75%) post treatment. Multivariable logistic regression was used to determine the demographic, clinical and treatment related factors that increased the risk for a high SIB score.ResultsFrom baseline to t1 there was a significant decrease in the proportion of those who endorsed SIB (68.7 vs. 38.9%, p < 0.0001). There was an increase in the proportion of those who endorsed SIB from t1 to t2 (38,9 vs. 47.1%, p = 0.047). There was a significant increase in the proportion of those reporting suicide likely in the near future from baseline to t1 (8.7 vs. 16.3%: p < 0.0049) and this was repeated from t1 to t2 (22.7%) (t1 vs. t2: p = 0.031). After controlling for all other variables, a comorbid mental illness (MI) at baseline was a significant independent risk factor for a high SIB score at t1(RR 1.63; 95% CL 1.30–2.03) (p < 0.0001) and a comorbid MI at t1 increased the risk for a high SIB score at t2 (RR 2.73; 95% CL 1.78–4.19) (p < 0.0001). A poorer general health score and poorer social functioning score at baseline were associated with a high SIB score at baseline (RR 1.02; 95% CL 1.01–1.04) (p = 0.001) and t2, respectively (RR 1.07; 95% CL 1.04–1.11) (p < 0.0001).ConclusionsAmong heroin users, a comorbid mental illness, poorer physical health and poorer social functioning are important factors to consider in suicide risk assessment. Although there were decreases in overall SIB 3 months after detoxification, this trend was not sustained at 9-month follow-up. After detoxification there were significant increases in the proportion of those reporting a likelihood of suicide in the following 3 months. The results suggests that the treatment exposure did not adequately mitigate suicide risk. There is a need for review of the treatment as well as targeted screening and management of SIB in heroin users attending treatment services.

Assessing and Responding to Suicide Risk in Health Research in Low-Resource Settings: Implementation of a Suicide Response Protocol in Ghana

Introduction: Risk for suicide is high in low and middle-income countries (LMICs) where over 75% of deaths by suicide occur. Thus, assessing for suicidal ideation and behavior and intervening appropriately when conducting research in LMICs is a critical step toward lowering risk for suicide among at-risk research participants. This is important even when conducting non-psychiatric research, especially when evaluating high-risk populations such as those experiencing bereavement. In this paper, we address questions that commonly arise as researchers in LMICs consider assessing for suicide risk. Key considerations: Using expert opinion and review of the literature, we discuss factors to consider when establishing an interdisciplinary research team and effectively assessing for and responding to suicide risk. We pose key questions and responses, using examples from a case study in which our team implemented a suicide assessment and response protocol as part of a research study on maternal mortality in Ghana, a LMIC. Through discussion of this case study, we demonstrate the feasibility and importance of (1) an interdisciplinary research team involving providers from the local community, (2) a practical framework for assessing suicide risk among study participants, and (3) a protocol to respond when risk is indicated. Assessing for suicidal ideation and behavior and intervening appropriately when conducting research in LMICs is a critical step toward lowering risk for suicide among at-risk research participants. Conclusions: By assessing for risk, appropriate care and follow-up can be provided with the goal of ultimately reducing the likelihood of suicide. To optimize impact, suicide risk protocols should be individualized to the specific setting, language, and available resources.

Leisure sedentary time and suicide risk among young adolescents: Data from 54 low- and middle-income countries

BackgroundThe dose-response association between sedentary time and suicidal ideation and planning among adolescents is unclear. This study examined the association between leisure sedentary time and suicidal ideation, planning and attempts among adolescents in low- and middle-income countries (LMICs). MethodsWe used the most recent data (2009–2016) from the Global School-based Student Health Survey (GSHS) in 54 LMICs. Leisure sedentary time and suicidal ideation, planning and attempts were assessed using a standardized questionnaire. A total of 146,345 young adolescents aged 12–15 years were included. ResultsAmong adolescents in the 54 LMICs, the prevalence of suicidal ideation was 14.8%, planning was 14.5%, and attempts was 13.0%. Compared with those who had less than 1 h/day of sedentary time, those who had 3, 4 h/day sedentary time were at higher odds ratio (OR) of suicidal ideation OR=1.21 (95% confidence interval (CI) =1.14–1.29), planning OR=1.15 (95%CI=1.07–1.22) and attempts OR=1.17 (95%CI=1.09–1.26), and those who had more than 8 h/day sedentary time were at OR=1.58 (95%CI=1.44–1.72), OR=1.44 (95%CI=1.31–1.58) and OR=1.27 (95%CI=1.16–1.40), respectively. LimitationsSuicidal behaviors and sedentary time were assessed by a self-reported questionnaire, which might be prone to recall bias. ConclusionsHigher amounts of leisure sedentary time are associated with suicidal ideation, planning and attempts among adolescents. Adolescents should spend less than 2 h/day of their sedentary time to reduce the likelihood of suicide.

Risk of suicide in patients who present to hospital after self-cutting according to site of injury: findings from the Multicentre Study of Self-harm in England.

We compared the risk of death by suicide following hospital presentation for self-harm according to site of self-cut/stab. We included 54 999 self-harm presentations (involving 31 419 individuals) to hospitals in the Multicentre Study of Self-harm in England (1/1/2004-31/12/2014), with mortality follow-up to 31/12/2019. Information on method of self-harm was obtained through monitoring in hospitals. Information about mortality was obtained through linkage with NHS Digital. We assessed the association of site of self-cut with death by suicide using mixed effect models. In total, 10 790 (19.6%) hospital presentations involved self-cutting/stabbing, 7489 of which (69.4%) were due to laceration to the arm/wrist alone, 1846 episodes (17.1%) involved cutting elsewhere on the body, and 1455 (13.5%) were due to laceration to unknown site. Controlling for confounders, presentation to a hospital following self-cut/stab to bodily parts other than wrist/arm was associated with greater chance of subsequent suicide relative to presentation after self-poisoning alone [adjusted odds ratio (aOR) 1.75, 95% confidence interval (CI) 1.03-2.96, p = 0.038]. The likelihood of suicide after presentation for cutting/stabbing the wrist/arm alone was comparable to that of patients who had self-poisoned alone. Presentations after laceration involving the neck were associated with a four-fold greater chance of subsequent suicide relative to self-poisoning (aOR 4.09, 95% CI 1.80-9.30, p = 0.001). Patients who attend hospital after self-cutting/stabbing are a heterogeneous group in terms of characteristics, methods of cutting/stabbing and risk of subsequent suicide. Risk of suicide is greater in individuals who self-cut/stab to parts of the body other than the wrist or arm, especially the neck.

Adverse childhood experiences and suicidality: school connectedness as a protective factor for ethnic minority adolescents

Adverse childhood experiences (ACEs) increase risk for suicidality. School connectedness can be protective, whether it buffers the negative effects of ACEs across ethnic backgrounds is understudied. Data came from the 2016 Minnesota Student Survey. The analytic sample included Latino (n = 11,888), Somali (n = 2,302), Hmong (n = 3,503), and non-Hispanic (NH) White (n = 10,968) adolescents. Multivariable logistic regression models, stratified by ethnicity and sex, examined associations between ACEs, school connectedness, and suicide ideation and attempts. More than 40% of students reported ≥1 ACE. Significant differences in suicidality across ethnicity and sex were noted, with Latinas reporting the highest rates and Somali boys and girls reporting some of the lowest. The likelihood of suicidality was significantly higher with each additional ACE (OR range 1.70–2.23), regardless of ethnicity or sex. School connectedness was generally protective against suicidal ideation; e.g., for each unit of school connectedness, the odds of ideation were 29% lower for Latinas (OR = 0.71; 95%, CI: 0.62, 0.80). However, it only buffered the impact of ACEs on suicidality for NH White adolescents. Suicide prevention programs should be designed through an intersectional framework and be adapted and relevant to promote social connectedness to increase access to tangible, emotional social support for youth of diverse ethnic backgrounds. Findings suggest further studies are needed to identify factors that moderate the impact of ACEs for all adolescents.

Considering the Role of the Menstrual Cycle on Increased Suicidality in Adolescent Females

Increased suicide in adolescent females calls for further study of potential risk and resiliency factors. Considering the relationship that menstrual cycle plays on mood and increased likelihood of suicidality in adult women, it is likely that a similar relationship is present in adolescents. The current review used PubMed and PsycInfo to assess articles related to menstrual cycle and suicide in adolescents. Limited data was present on the role that menstrual cycle and related disorders such as PMS and PMDD has on the worsening of mood symptoms and suicidal ideation and attempts, with minimal research conducted on adolescents. This review identifies a gap in research regarding premenstrual distress as a potential risk factor for suicidal ideation and attempts in adolescents. The present review suggests future routes for research in this area and the impacts that a better understanding of the complex relationship between menstrual cycle and suicide could provide in order to minimize the impact of menstrual distress on suicidality.

A systematic review and meta-analysis of offending versus suicide in community (non-psychiatric and non-prison) samples

This study sought to meta-analytically establish whether community offenders, without mental illnesses, were more likely to commit suicide compared with community and general population comparison groups. Fifteen studies met our inclusion criteria (N = 602,347) and highlight that community offenders are significantly more likely to commit suicide compared with non-offenders (OR = 4.54) at any age. Ex-prisoners had a high likelihood of suicide (OR = 4.18), but not as high as offenders who had not been incarcerated (OR = 7.62). Community offenders therefore form a vulnerable group who require targeted intervention to reduce the incidence of suicide across the lifespan. The antisocial lifestyles that offenders lead, when out of secure environments, pose a significant risk to health and should be viewed as a future public health challenge. A shared responsibility lies with the prison, probation, health and social services to develop more collaborative practices in providing services for this high-risk group.

Concerns about Suicide among Asian Americans: The Need for Outreach?

Suicide was the ninth leading cause of death for Asian Americans in 2017. The growth of Asian American populations has led to more discussions about suicide prevention efforts. A 128-item needs assessment survey was administered at cultural events in 10 predominantly immigrant Asian communities. In five years, 1,840 respondents (61 percent response rate) filled out the survey anonymously to express their health and mental health concerns. This study aims to identify factors and help-seeking behaviors associated with having suicidal concerns among Asian Americans in various subgroups. Among the respondents, 1,314 rated the intensity of their concerns about suicide with an average of 0.74 (SD = 1.11) on a four-point rating scale in that 13.7 percent rated their concerns as severe. Taiwanese respondents expressed the highest intensity score (1.09) compared with other ethnic groups (from 0.29 to 1.04). A logistic regression analysis found that each unit of health concerns on a four-point rating scale significantly increases the likelihood of suicide concerns by 46 times among Asian Americans. Consistent with previous studies, immigrants were likely to share mental health problems with friends and physicians. Effective suicide prevention requires mental health awareness programming for the Asian American community.

Sleep and suicidality in school-aged adolescents: A prospective study with 2-year follow-up

Current evidence about the association between sleep and suicide are conflicting. This study aimed to investigate the association between sleep duration and quality with suicidal behaviors in a group of school-aged adolescents in China. The baseline survey was conducted among Chinese adolescents aged 12—13 years in October 2016. All participants were asked to complete a self-administered questionnaire. After 2 years follow-up, a total of 1513 adolescents completed the follow-up. The multivariable logistic regression analysis showed that shorter sleep duration (<8 h per night) in baseline was associated with an increased likelihood of suicidality in boys [suicidal ideation, adjusted odds ratio (OR)=2.18, 95% confidence interval (CI)=1.97 to 3.98; suicide planning, OR=2.47, 95% CI=1.22 to 5.01; suicide attempt, OR=2.97, 95% CI=1.39 to 6.38]. Similarly, poor sleep quality [Pittsburgh Sleep Quality Index (PSQI) ≧ 5] was associated with an increased likelihood of suicidal ideation and suicide planning in boys (OR=2.14, 95% CI=1.15 to 3.99 and OR=2.47, 95% CI=1.16 to 5.25, respectively). This study indicates that school-aged boys are more likely to experience suicidality in exposure to short sleep or poor sleep quality.

Feeling hopeful: can hope and social support protect prisoners from suicide ideation?

ABSTRACTSuicide is a major concern in custodial settings with prisoners identified as a high risk group. Much previous research is limited to focussing upon factors associated with increased likelihood of suicide. The current study investigates the potentially protective factors of hope and social support in a sample of 100 suicidal prisoners. Hope, especially the sub-component of agency thinking, and the perceived availability of social support were significantly related with lower levels of suicidal ideation. Prison suicide prevention efforts may benefit from incorporating hope focussed assessments and treatments. They should also consider an individual’s need for increased availability of social support.

Risk of Suicide and Self-harm in Kids: The Development of an Algorithm to Identify High-Risk Individuals Within the Children\u2019s Mental Health System

Suicide is the second leading cause of death in adolescents within Canada. While several risk factors have been found to be associated with increased risk, appropriate decision-support tools are needed to identify children who are at highest risk for suicide and self-harm. The aim of the present study was to develop and validate a methodology for identifying children at heightened risk for self-harm and suicide. Ontario data based on the interRAI Child and Youth Mental Health Screener (ChYMH-S) were analyzed to develop a decision-support algorithm to identify young persons at risk for suicide or self-harm. The algorithm was validated with additional data from 59 agencies and found to be a strong predictor of suicidal ideation and self-harm. The RiSsK algorithm provides a psychometrically sound decision-support tool that may be used to identify children and youth who exhibit signs and symptoms noted to increase the likelihood of suicide and self-harm.