Brooding and reflective rumination among suicide attempters: Cognitive vulnerability to suicidal ideation

Previous research suggests that the brooding subtype of rumination is associated with increased suicidal ideation, but findings are inconsistent with respect to reflection, considered to be the more adaptive form of rumination. This study investigated the circumstances under which reflective rumination might be associated with increased suicidal ideation by examining whether a suicide attempt history moderated the relationship between the ruminative subtypes and current suicidal ideation. Thirty-seven young adults who reported a past suicide attempt and fifty-nine young adults without a suicide attempt history completed measures of rumination and depression symptoms in an initial study session. They then completed a measure of suicidal ideation and hopelessness during a second study session. Overall, brooding was associated with higher self-reported suicidal ideation, whereas reflection was not significantly associated with ideation. However, reflection - but not brooding - interacted with suicide attempt history to statistically predict suicidal ideation, even after adjusting for symptoms of depression and hopelessness, whereas brooding no longer predicted ideation after adjusting for these symptoms. These findings qualify earlier suggestions that reflection is a more adaptive form of rumination by indicating that among vulnerable individuals - in particular those with a history of a suicide attempt - a higher degree of reflective rumination is associated with increased suicidal ideation.     

Toward an integrative model of suicide attempt: a cognitive psychological approach.

Applying a cognitive approach, the purpose of the present study was to expand previous research on stress-vulnerability models of depression and problem-solving deficits, as it relates to suicide attempt. Structural equation modelling, involving latent variables, was used to evaluate (a) whether low self-esteem, a low sense of self-efficacy, loneliness, and divorce constituted vulnerability factors for the development of depression; (b) whether hopelessness and suicidal ideation mediated the relationship between depression and suicide attempt; and (c) whether problem-solving deficits mediated the relationship between the vulnerability factors and suicide attempt, separate from depression/hopelessness. A total of 123 individuals, aged 18-75 years, participated in the study (72 suicide attempters and 51 psychiatric outpatients with no history of suicidal behavior). The results indicated a two path model of suicide attempt. The first path began with low self-esteem, loneliness, and separation or divorce, which advanced to depression, and was further mediated by hopelessness and suicidal ideation which led to suicide attempt. The second path developed from low self-esteem and a low sense of self-efficacy and advanced to suicide attempt, mediated by a negative appraisal of one's own problem-solving capacity, and poor interpersonal problem-solving skills. The importance of addressing both depression/hopelessness, and problem-solving deficits when working with suicide attempters is noted.     

The Interpersonal Theory of Suicide Applied to Male Prisoners

The interpersonal theory of suicide proposes that severe suicide ideation is caused by the combination of thwarted belongingness (TB) and perceived burdensomeness (PB), yet few studies have actually examined their interaction. Further, no studies have examined this proposal in male prisoners, a particularly at‐risk group. To address this gap, the current study surveyed 399 male prisoners. TB and PB interacted to predict suicide ideation while controlling for depression and hopelessness. High levels of both TB and PB were associated with more severe suicide ideation. The interpersonal theory may aid in the detection, prevention, and treatment of suicide risk in prisoners.     

Current suicide proneness and past suicidal behavior in adjudicated adolescents

Youth recently assigned to probation (n = 233) were assessed for current suicide proneness, depression, and hopelessness, as well as for recent suicide ideation, previous suicide ideation, or suicide attempt(s). The Life Attitudes Schedule-Short Form (LAS-SF) was used to assess suicide proneness. As per the LAS-SF, suicide proneness was defined broadly to include current engagement in overtly suicidal behavior as well as in risk-taking and potentially injury-producing behaviors, coupled with a lack of engagement in health and safety behaviors, or self-enhancement behaviors. As expected, current suicide proneness was significantly associated with a history of suicide ideation and attempts, recent ideation, and current depression and hopelessness for adjudicated youth. Gender differences were obtained between the strength of the association between suicide proneness and depressive symptoms. A subgroup of adjudicated youth (n = 39) was then interviewed about their suicidal behaviors. Among other things, these youth indicated that the majority of their previous suicide attempts were committed impulsively.     

Perfectionism,Stress, Daily Hassles,Hopelessness, and Suicide Potential in Depressed Psychiatric Adolescents

The current study examined dimensions of perfectionism, stress, hopelessness, and suicidality in a sample of adolescent psychiatric patients diagnosed with depression. This study evaluated the unique contribution of perfectionism in predicting suicidality after considering other predictors (i.e., hopelessness, depression) and it also examined the diathesis-stress model of perfectionism and suicide. A sample of 55 adolescents (41 females, mean age = 15.53, 25.5 % ethnic/racial minorities) who were psychiatric patients completed measures including the Child-Adolescent Perfectionism Scale, subjective and objective indices of life stress, daily hassles, depression, hopelessness, suicide ideation, prior attempts and suicide potential. In addition, other informants (i.e., adolescents’ parents) completed a diagnostic interview and an interview assessing major stressful experiences. Socially prescribed perfectionism (i.e., the perception that others require perfection of oneself) predicted concurrent levels of suicide potential and this association with suicide potential held even after controlling for the variances accounted for by depression and hopelessness. Hierarchical regression analyses provided partial support for the diathesis-stress model, that is, socially prescribed perfectionism interacted with daily hassles to predict concurrent suicide potential even after controlling for depression, hopelessness, and prior suicide attempt. Together, these findings suggest that socially prescribed perfectionism acts as a vulnerability factor that is predictive of suicide potential or risk among clinically depressed adolescents.     

Suicidality and psychosis: beyond depression and hopelessness

The present study examined recent suicide attempters with and without psychotic disorders in order to understand factors that contribute to suicide ideation during and following the suicide attempt. Patients with psychotic disorders endorsed higher levels of suicide ideation than patients without psychotic disorders. Even when depression, hopelessness, substance abuse, and social problem solving were controlled for, there was a significant association between psychotic disorder and suicide ideation. During the follow-up period, patients with psychotic disorders subsequently attempted suicide at a significantly higher rate than patients without psychotic disorders. The clinical relevance of these findings is discussed.     

Suicidal ideation and attitudes toward suicide

Although hopelessness and depression are known risk factors for suicide, most individuals who are hopeless or depressed never make a suicide attempt. In this study, we tested the hypothesis that college students' (n = 230) attitudes toward suicide (the degree to which they see it as an acceptable option under some circumstances) would moderate the link between both hopelessness and depressive symptoms and their levels of suicidal ideation. This moderation hypothesis was supported, but only among men. Specifically, among men, levels of hopelessness and depressive symptoms were significantly related to suicidal ideation among only those with relatively positive attitudes toward suicide.     

Factors Associated with Suicide Ideation in Severely Obese Bariatric Surgery‐Seeking Individuals

There are high rates of suicide ideation and/or behavior in severely obese individuals. The potential contributors to suicide ideation in a sample of 334 severely obese bariatric surgery candidates was explored. Lack of college education, a history of suicide ideation and/or behavior, psychological distress, hopelessness, loneliness, history of physical and/or sexual abuse, and lifetime major depression were associated with current suicide ideation. Some of the correlates of suicide ideation in severely obese bariatric surgery‐seeking samples are similar to those found in the general community and this knowledge may serve to improve the psychological assessment and care for this group.     

Naturalistic evaluation of suicidal ideation: variability and relation to attempt status

Suicidal ideation has been thought to have a relatively stable course across weeks and months. However, daily changes in levels of ideation have not been adequately examined despite the importance of potential variability clinically and conceptually. For example, it has been suggested that variability in suicidal ideation may become less closely tied to variability in other mood symptoms (e.g., depression, hopelessness) among individuals with multiple suicide attempts. The present report had two related goals: (1) to prospectively evaluate suicidal ideation and related mood symptoms, and (2) to determine whether suicide attempt status predicted a decreased association between ideation and other mood symptoms. Non-clinical participants (N=108) with varying levels of suicidal ideation and number of previous suicide attempts completed the beck hopelessness scale (BHS), beck depression inventory (BDI), and suicide probability scale (SPS) every day for 4 weeks. Findings suggested considerable variability in suicidal ideation, especially for multiple attempters. Multiple attempt status predicted a decreased association between suicidal ideation and depression, although the results were only marginally significant. These findings have implications for conceptual models of suicide risk as well as assessment and treatment of suicidal individuals.     

2010~2020中国内地大学生心理健康问题检出率的元分析

估计我国大学生心理健康问题的检出率, 能够为心理健康政策完善和教育活动开展提供证据支持。对2010~2020年我国大学生主要心理健康问题检出率及影响因素进行元分析, 结果表明, 睡眠问题、抑郁、自我伤害在大学生中较为突出; 近10年, 大学生焦虑、抑郁、睡眠问题和自杀未遂的检出率显著上升, 自我伤害的检出率显著下降; 测量工具、检出标准和检出时间是导致检出率大小不一的关键因素; 整体而言, 东北和中部地区大学生的心理健康情况优于西部和东部大学生; 性别、生源地、独生与否对大学生心理健康问题检出率的影响均不显著。未来应重视研制适合我国大学生的心理健康测评工具并确定检出标准, 同时据此积极开展心理行为问题的筛查与控制。     

Self‐Esteem and Suicide Ideation in Psychiatric Outpatients

Depression, hopelessness, and low self‐esteem are implicated as vulnerability factors for suicide ideation. The association of self‐esteem with suicide ideation after controlling for depressed mood and hopelessness was examined. Adult psychiatric outpatients (N = 338) completed measures of self‐esteem, suicide ideation, hopelessness, and depression. Self‐esteem was operationalized as beliefs about oneself (self‐based self‐esteem) and beliefs about how other people regard oneself (other‐based self‐esteem). Each dimension of self‐esteem was negatively associated with suicide ideation after controlling for depression and hopelessness. Of the two dimensions of self‐esteem, other‐based self‐esteem was the more robust predictor of suicide ideation. These findings suggest that even in the context of depression and hopelessness, low self‐esteem may add to the risk for suicide ideation.     

When simplifying life is not so bad: the link between rigidity, stressful life events, and mental health in an undergraduate population

Decades of research have generally shown that being more rigid is associated with poorer mental health. We investigated whether all aspects of what has been termed “rigidity” are harmful. In particular, we hypothesized that the desire for simple structure (DSS) will not be associated with poor mental health, and in some cases might be associated with better mental health. In contrast, the intolerance of uncertainty (IU) was hypothesized to be associated with a wide range of indices of poor mental health. We also hypothesized that people high in IU would be less resilient in the face of stressful life events. Results across two cross-sectional surveys (N=240; N=331) supported our hypotheses. DSS was associated with less hopelessness, whereas IU was associated with more depression, anxiety, stress, suicidal ideation, and hopelessness. In addition, moderational analysis supported the hypothesis that IU magnifies the adversive effect of stressful life events on depression, anxiety and hopelessness. IU was more strongly related to the negative indices of well-being than to the positive index of life satisfaction. The implications of these findings for cognitive behavioural therapy practice are discussed.     

Concurrent validity of a stress-vulnerability model of suicidal ideation and behavior: a follow-up study

A follow-up study to test the concurrent validity of a stress-vulnerability model of suicidal ideation and behavior was conducted. A total of 202 college students (139 females, 63 males) completed self-report measures of life stress, loneliness, depression, dysfunctional cognitions, reasons for living, hopelessness, current suicide ideation, and predictions of future suicide probability. The results of a multiple-regression analysis indicated that 30% of the variation in suicide ideation scores could be accounted for by the linear combination of negative life stress, depression, loneliness, and few reasons for living. The linear combination of current suicide ideation, hopelessness, dysfunctional cognitions, and few reasons for living explained 56% of the variance in self-predicted future suicide probability. The results are interpreted as being supportive of the proposed model.     

Dimensions of Perfectionism,Hopelessness, and Attempted Suicide in a Sample of Alcoholics

This study assessed whether specific dimensions of perfectionism and hopelessness were elevated in individuals who had made a serious suicide attempt in comparison to individuals with no history of suicide attempts. A sample of 39 inpatients with alcoholism who had made a serious suicide attempt and a matched sample of 39 inpatients with alcoholism but no history of suicide attempts completed the Multidimensional Perfectionism Scale, the Hopelessness Scale, ratings of achievement and social hopelessness, and the Beck Depression Inventory. The attempter group had higher scores on socially prescribed perfectionism, generalized hopelessness, achievement hopelessness, social hopelessness, and depression. A discriminant function analysis revealed that depression, social hopelessness, socially prescribed perfectionism, and other-oriented perfectionism were unique discriminators of the suicide groups. The results are discussed in terms of the importance of social personality variables in attempted suicide.     

2010~2020中国内地初中生心理健康问题检出率的元分析

初中生心理健康问题的检出率在诸多研究中存在很大分歧, 未能为心理健康政策制定和服务体系建设提供充分依据。为明确心理健康问题的整体检出率并澄清其影响因素, 对2010~2020年检索到的文献进行了元分析。结果发现, 初中生面临不同程度的心理健康问题, 其中焦虑、抑郁和自我伤害检出率排在前三位; 初中生心理健康问题随年代发展呈恶化趋势, 其中焦虑和自杀企图尤为明显; 初中生心理健康问题检出率饱受测量工具、检出标准和检出时间不统一的影响; 初中生心理健康问题检出率整体上随年级而增加, 其中焦虑尤为明显; 女生的心理健康问题检出率高于男生, 自杀尤为明显; 中西部地区的初中生比东北和东部地区更容易出现心理健康问题, 尤其是焦虑和自我伤害。未来应立足中国大地研制科学的测量工具和筛查标准并建立心理健康动态监测体系和学校心理健康服务体系。     

师范生职业认同与自杀意念的关系:抑郁的中介作用及其性别差异

基于心理健康的社会学模型和社会-文化模型,本研究考察师范生职业认同与自杀意念之间的关系,以及性别的调节效应和抑郁的中介效应。被试为700名师范生,研究工具包括师范生职业认同感量表、自杀意念自评量表、流调中心用抑郁自评量表。结果表明：（1）职业认同得分、自杀意念检出率的性别差异显著;（2）职业认同与抑郁、自杀意念均呈显著的负相关,自杀意念和抑郁呈显著的正相关;（3）性别在职业认同负向预测自杀意念的关系中起到调节作用,该调节作用还部分通过抑郁这一中介变量来实现。     

Relations between social and emotional competence and mental health: a construct validation study

Researchers working fairly independently of each other have created numerous measures of social and emotional competence (SEC). These measures tend to correlate (sometimes highly) with each other and with measures of stressful events, suggesting potential redundancy. We evaluated which, if any, SEC variables predicted unique variance in social and mental health after controlling for other SEC variables in the study and the impact of stressful events. Three-hundred and thirty-one university students participated in an anonymous, cross-sectional study. We measured stressful events, and a wide variety of SECs, including: social problem solving skill (effective problem orientation, automatic processing, and problem solving), alexithymia (difficulty identifying and describing emotions; minimising emotions), effective emotional control (low rumination, high impulse control, high aggression control, low defensive inhibiting of emotions), and level of emotional awareness. We also assessed a variety of aspects of social and mental health (e.g. depression, anxiety, hopelessness, suicidal ideation, life satisfaction, social support). Covariance analyses revealed that all SEC measures except minimising emotions had significant incremental value over the other measures and over stressful events in predicting social and mental health. The optimal set of predictors differed depending upon the type of health predicted. These findings have important implications for the design of social and emotional intervention programs.     

Are Reports of Life Event Stress among Suicidal Youth Subject to Cognitive Bias?

Severity of depressive symptoms, hopelessness, and suicidal ideation were examined to determine whether they were significantly associated with the accuracy of suicidal adolescents' ratings of stressful life events. The sample included 130 inpatient adolescents who endorsed suicide‐related behaviors. Stress interviews were administered, and the severity of stressful events was rated separately by adolescents and an independent team. A residualized cognitive bias score was created by regressing adolescents' severity ratings to the independent team's severity ratings of the same events. Depressive symptoms, but not hopelessness or suicidal ideation, were significantly associated with cognitive bias scores. A negative cognitive bias in adolescents' reports of life stress may be present at higher levels of depression relative to minimal levels of depression. Further research on the relations between stress and suicide‐related behaviors is encouraged to include independent ratings of stress severity.     

Suicide attempts and ideation: adolescents evaluated on a pediatric ward

This study compared psychological, familial, and demographic data for 42 suicidal, 16 suicide ideation, and 42 control pediatric patients. Chaotic families and behavior problems, as well as depression, constriction, and lack of insight, differentiated the suicide attempt group from the control group. The suicide ideation group was similar to both the control and suicide attempt groups and seen as "intermediate" between these two. In assessing lethality of the attempt, constriction was the only predictor differentiating the serious from less serious suicide attempt.     

Adolescent suicide risk: four psychosocial factors

Suicide is a leading cause of death among adolescents. This study examined the suicidal ideation, behavior, and attempt history of 100 adolescents ages seventeen to nineteen. Four psychosocial factors were found to be important for overall suicide risk: hopelessness, hostility, negative self-concept, and isolation. It is suggested that focusing on these four psychosocial factors would enhance suicide assessment and prevention efforts with adolescents.