Purpose in Life, Satisfaction with Life, and Suicide Ideation in a Clinical Sample

This study examined the role of purpose in life and satisfaction with life in protecting against suicide ideation in a clinical psychiatric sample. Forty-nine psychiatric patients completed self-report measures of suicide ideation, purpose in life, satisfaction with life, neuroticism, depression, and social hopelessness. Zero-order correlations indicated significant associations between suicide ideation and the various predictors, in the hypothesized directions. Regression analyses illustrated that purpose in life and satisfaction with life accounted for significant additional variability in suicide ideation scores above and beyond that accounted for by the negative psychological factors alone. Purpose in life also mediated the relation between satisfaction with life and suicide ideation and moderated the relation between depression and suicide ideation. These findings demonstrate the potential value of attending to both resilience and pathology when building predictive models of suicide ideation and of attending to key existential themes when assessing and treating suicidal individuals.     

Subjective Well-Being of Older African Americans with DSM IV Psychiatric Disorders

This study examined demographic and mental health correlates of subjective well-being (i.e., life satisfaction, happiness) using a national sample of older African Americans with psychiatric disorders. We used a subsample of 185 African Americans, 55 and older with at least one of thirteen lifetime psychiatric disorders from The National Survey of American Life: Coping with Stress in the Twenty-first Century. The findings indicated that among this population of older adults who had a lifetime psychiatric disorder, having a lifetime suicidal ideation was associated with life satisfaction but not happiness. Further, having a 12-month anxiety disorder or a lifetime suicidal ideation was not associated with happiness. Having a 12-month mood disorder, however, was negatively associated with an individual’s level of happiness, as well as their life satisfaction. Additionally, there were two significant interactions. Among men, employment was positively associated with life satisfaction, and marriage was associated with higher levels of happiness among men but not women. The overall pattern of findings reflects both similarities and departures from prior research confirming that well-being evaluations are associated with multiple factors.     

The utility of MMPI-2 suicide items for assessing suicidal potential: development of a Suicidal Potential Scale

The assessment of suicidal potential is one of the most challenging and stress-inducing tasks facing clinicians. Studies that have attempted to identify specific MMPI codetypes, scales, or individual items predictive of completed suicide have produced inconsistent findings. This study focused on the relationship between the six most direct MMPI-2 suicide items (Items 150, 303, 506, 520, 524, and 530) and verbally reported history of suicidal ideation and behavior among a sample of psychotherapy outpatients (n =116). These six MMPI-2 suicide items provided valuable information regarding suicidal ideation and behavior above and beyond that of verbal self-report. These items were grouped together to create a single scale, the Suicidal Potential Scale (SPS) that manifested strong internal consistency. The SPS provides the clinician with a reliable method of assessing for self-reported suicidal ideation and behavior.     

Alcohol use disorders and risk factor interactions for adolescent suicidal ideation and attempts.

Four hundred eighty-two adolescents who were diagnosed with at least one mental disorder were studied to determine the predictors of suicidal ideation and suicide attempts. Major depression was predictive of suicidal ideation and suicide attempts for both genders. Chronic stress was found predictive of male suicidal ideation, while low self-esteem and high family dysfunction were found to be predictive of suicidal ideation in females. Statistical trends suggest that females with comorbid alcohol use/conduct disorder were approximately three times more likely to have attempted suicide than those with only one of these conditions. Clinicians working with adolescents should be aware that, while depression remains the number one clinical risk forsuicidal behavior, risk factors for suicidal ideation may be different than those for attempted suicide and may vary by gender.     

Basic Psychological Needs,Suicidal Ideation,and Risk for Suicidal Behavior in Young Adults

Associations between the satisfaction of basic psychological needs of autonomy, competence, and relatedness with current suicidal ideation and risk for suicidal behavior were examined. Two logistic regressions were conducted with a cross‐sectional database of 440 university students to examine the association of need satisfaction with suicidal ideation and risk for suicidal behavior, while controlling for demographics and depressive symptoms. Suicidal ideation was reported by 15% of participants and 18% were found to be at risk for suicidal behavior. A one standard deviation increase in need satisfaction reduced the odds of suicidal ideation by 53%, OR (95% CI) = 0.47 (0.33–0.67), and the odds of being at risk for suicidal behavior by 50%, OR (95% CI) = 0.50 (0.37–0.69). Young adults whose basic psychological needs are met may be less likely to consider suicide and engage in suicidal behavior. Prospective research is needed to confirm these associations.     

Acculturative stress, depression, and suicidal ideation in Mexican immigrants

This study examined the relationship among acculturative stress, depression, and suicidal ideation in a sample of Mexican immigrants. Also examined were variables that predict depression and suicidal ideation. Multiple regression analyses revealed that acculturative stress significantly predicted depression and suicidal ideation and that family support, social support, religiosity, agreement with the decision to migrate, and expectations for the future were significant predictors of depression and suicidal ideation. The overall findings suggest that adult Mexican immigrants who experience elevated levels of acculturative stress may be at risk for experiencing critical levels of depression and suicidal ideation. The findings highlight the importance of using culturally relevant clinical methods when assessing and treating the depressed and potentially suicidal acculturating individual.     

Low self‐esteem,entrapment, and reason for living: A moderated mediation model of suicidal ideation

Adolescent suicidal ideation has become a top public health concern. It is thus significant to explore both risk and protective factors of adolescent suicidal ideation. The present study tested a moderated mediation model of suicidal ideation in a sample of Chinese adolescents. Chinese adolescents of 1074 (54.2% females, aged between 11 and 18 years) completed questionnaires assessing self‐esteem, entrapment, reason for living, and suicidal ideation. We found that entrapment mediated the association between low self‐esteem and suicidal ideation. The association between entrapment and suicidal ideation was moderated by reason for living. Findings of this study may expand our understanding of the development of suicidal ideation, and facilitate future research exploring the interplay of risk and protective factors of suicidality. Clinical implications of these findings were also discussed.     

Stress, self-esteem, and suicidal ideation in late adolescents

The relationships among stress, self-esteem, and suicidal ideation in late adolescents were examined in a group of college students. Multiple regression analysis indicated that both stress and self-esteem were significantly related to suicidal ideation; low self-esteem and stressful life events significantly predicted suicidal ideation. The hypothesis that self-esteem would moderate the effects of life stressors on suicidal ideation was supported at the .06 level. A significant minority of the sample indicated having thoughts severe enough to be classified as clinical suicidal ideation. In general, participants who had experienced negative life events in the 6 to 12 months prior to participating in the study had lower self-esteem than those who had similar stresses within the prior six months. However, the opposite was true for clinical suicidal ideators; those who experienced negative life stressors recently had lower self-esteem than those who experienced negative life events six months to a year in the past.     

Self-Esteem and Social Support as Moderators of Depression,Body Image,and Disordered Eating for Suicidal Ideation in Adolescents

The current study investigated risk factors for suicidal ideation in a community sample of 392 adolescents (males 51.9 %; females 48.1 %), while also evaluating self-esteem, perceived parent support, and perceived peer support as protective factors and potential moderators between suicidal ideation and the 3 risk factors. Disordered eating, depression, parent support, and peer support were found to be significant predictors of current suicidal ideation, but body satisfaction was not. The relationship between depression and suicidal ideation was significantly moderated by both self-esteem and parent support, while the relationship between disordered eating and suicidal ideation was significantly moderated by peer support. Results underscore the importance of examining protective factors for suicide risk, as they have the potential to reduce suicidal ideation in adolescents.     

Gender differences in the psychosocial correlates of suicidal ideation among adolescents.

Gender differences in the psychosocial correlates of suicidal ideation were studied. A sample of 613 high school students (ages 14-19) completed measures of suicidal ideation, depression, hopelessness, life stress, loneliness, alcohol and drug use, and reasons for living. The results of a discriminant function analysis indicated that males reported higher loneliness and substance abuse scores than females whereas females reported greater suicidal ideation, depression, and reasons for living. The results of multiple regression analyses found that, although the same four variables, depression, hopelessness, substance abuse, and few reasons for living emerged as significant predictors of suicidal ideation in both samples, the predictive equation accounted for more of the variance in ideation scores in females (57%) than in males (46%). In a final analysis a discriminant function analysis of the subscales of the reasons for living inventory revealed that females have a greater fear of death and injury whereas males have a greater fear of social disapproval over having suicidal thoughts. This may account for the greater rate of suicide completing among males. Fear of social disapproval, more anger and impulsivity, and less help-seeking behavior among males are offered as potential variables to explain the observed gender differences.     

Toward a predictive model of suicidal ideation and behavior: some preliminary data in college students

Within a multivariate statistical design, the relationship of various interpersonal, emotional, and cognitive variables to suicidal ideation and behavior in college students was examined. A total of 158 subjects (58 males, 100 females) completed self-report measures of life stress, faulty cognitions, loneliness, depression, hopelessness, family cohesiveness, adaptive reasons for living, and suicidal ideation and behavior. The results of a multiple-regression analysis, forward-inclusion algorithm, indicated that a predictive equation consisting of loneliness, irrational beliefs, and low adaptive reasons for living best accounted for suicidal behavior scores. To determine the basic structures and power of the predictor variables under study, a factor analysis and composite regression were employed, resulting in a predictive equation consisting of three factors: Social/Emotional Alienation, Cognitive Distortions, and Deficient Adaptive Resources. Results are discussed in terms of an interactional model of suicidal behavior.     

Self-Reported Emotion Reactivity Among Early-Adolescent Girls: Evidence for Convergent and Discriminant Validity in an Urban Community Sample

Emotion reactivity, measured via the self-report Emotion Reactivity Scale (ERS), has shown unique associations with different forms of psychopathology and suicidal thoughts and behaviors; however, this limited body of research has been conducted among adults and older adolescents of predominantly White/European ethnic backgrounds. The present study investigated the validity of ERS scores for measuring emotion reactivity among an urban community sample of middle-school-age girls. Participants (N = 93, ages 11–15, 76% African-American, 18% Latina) completed the ERS and measures of emotion coping, internalizing problems, proactive and reactive aggression, negative life events, and lifetime suicidal ideation and substance use. As hypothesized, ERS scores were significantly associated with internalizing problems, poor emotion coping, negative life events, reactive aggression, and suicidal ideation (evidence for convergent validity), but showed little to no association with proactive aggression or lifetime substance use (evidence for discriminant validity). A series of logistic regressions were conducted to further explore the associations among internalizing problems, emotion reactivity, and suicidal ideation. With depressive symptoms included in the model, emotion reactivity was no longer uniquely predictive of lifetime suicidal ideation, nor did it serve as a moderator of other associations. In conjunction with previous research, these findings offer further support for the construct validity and research utility of the ERS as a self-report measure of emotion reactivity in adolescents.     

Predictive testing for HD: maximizing patient autonomy

In "The Ethical Justification for Minimal Paternalism in the Use of the Predictive Test for Huntington's Disease," David DeGrazia attempts to provide a rational analysis of the exclusion criteria and counseling requirements for predictive testing proposed by the Huntington's Disease Society of America (HDSA). The need for analysis is clear. These protocols and procedures for predictive testing for Huntington's disease (HD) are being used as models for testing programs for any number of genetic conditions. DeGrazia concludes that the HDSA guidelines are reasonable, a conclusion with which I agree. However, I believe that DeGrazia, by placing his analysis within the framework of autonomy versus paternalism, overlooks both the fundamental rationale for the testing procedures and the true barriers to testing....The difficulties encountered during the testing process clearly demonstrated the failure of abstract principles to deal with real life.     

The moderating effect of humor style on the relationship between interpersonal predictors of suicide and suicidal ideation

This study investigated how positive and negative humor styles relate to suicidal ideation, thwarted belongingness, and perceived burdensomeness. Analyses indicated that affiliative and self-defeating humor style moderated the relationships between thwarted belongingness and suicidal ideation as well as perceived burdensomeness and suicidal ideation when controlling for depression. The clinical importance of assessing and tracking humor styles as potential coping mechanisms against suicidal thinking is discussed.     

Mediators of a Culturally-Sensitive Intervention for Suicidal African American Women

This study explored intervention outcomes and mechanisms that could help explain why low-income, African American women with a history of intimate partner abuse and suicide attempt improve in response to a culturally-informed intervention, the Grady Nia Project. Specifically, the investigation examined whether or not the intervention had effects on the women and whether or not spiritual well-being and coping mediated the effects of the intervention on suicidal ideation and depressive symptoms. In this randomized controlled clinical trial, data from 89 women who completed both pre- and post-intervention assessments were analyzed. During the post-intervention follow-up, women in the active intervention group reported lower levels of suicidal ideation and depressive symptoms and higher levels of existential well-being and adaptive coping skills than those women randomized to the treatment as usual group. However, only existential well-being was found to mediate treatment effects on suicidal ideation and depressive symptoms. Religious well-being, as well as adaptive and maladaptive coping, did not serve a mediational function. These findings highlight the importance of designing and implementing culturally-sensitive and evidence-based strategies that enhance existential well-being in this population.     

Acculturative stress, depression, and suicidal ideation among Central American immigrants

No previous studies have examined suicide risk among Central American immigrants. The present study explored the relationship between acculturative stress, depression, and suicidal ideation among Central American immigrants. Also examined were variables that predict depression and suicidal ideation. Elevated levels of acculturative stress were significantly correlated with high levels of depression and suicidal ideation. Family dysfunction, ineffective social support, nonpositive expectations concerning the future, low levels of religiosity, low levels of education and income, and lack of agreement with the decision to immigrate were significantly associated with high levels of depression and suicidal ideation. The overall findings suggest that Central American immigrants who experience elevated levels of acculturative stress may be at risk for experiencing heightened levels of depression and suicidal ideation. The findings highlight the importance of using culturally relevant clinical methods when assessing and treating depressed and potentially suicidal acculturating individuals.     

A Longitudinal Investigation of Depression,Hopelessness, Social Support,and Major and Minor Life Events and Their Relation to Suicidal Ideation in Adolescents

The longitudinal relationship of psychological and social-environmental factors with adolescent suicidal ideation over a 1-year-period was examined in a sample of 374 high school students. Students were assessed twice over a 1-year period with measures of depression, hopelessness, major negative life events, daily hassles, social support, and suicidal ideation. At the initial assessment, daily hassles and negative life events for males and social support and depression for females were significant factors related to suicidal ideation levels 1 year later. Changes in depression and hopelessness were significantly related to changes in suicidal ideation over the 1 year interval for males and females. Differences found between males and females in the relationship of psychological and social-environmental variables with suicidal ideation supports the need to examine gender specific relationships when conducting research on suicidal behavior in adolescents.     

An integrative model of suicidal ideation

An integrative path model is presented that details the relationships among several demographic variables, life stress, depression, hopelessness, social support, and suicidal ideation. The sample consisted of 737 university students, 287 males and 450 females. Negative life stress was found to be a significant predictor of both depression and hopelessness, which, in turn, mediated the relationship between life stress and suicidal ideation. Contrary to previous findings, depression proved to be a better predictor of suicidal ideation than hopelessness. Findings also illustrated the importance of including social support measures in the model, as significant relationships were discovered between social support and both life stress and suicidal ideation. The model accounted for a total of 34% of the variance in suicidal ideation. Individual findings are interpreted; the ways in which they reflect on previous research, and future efforts, are discussed.     

Contributors to suicidal ideation among bipolar patients with and without a history of suicide attempts

This study was designed to develop models for vulnerability to suicidal ideation in bipolar patients. Logistic regression models examined correlates of suicidal ideation in patients who had versus had not attempted suicide previously. Of 477 patients assessed, complete data on demographic, illness history, and personality variables were available on 243. The regression models achieved positive predictive values of 55% and 59% for the attempter (N = 92) and nonattempter groups (N = 151), respectively. Depression was cross-sectionally associated with suicidal ideation in both the attempter and nonattempter groups but made a smaller contribution among attempters. Poor psychosocial adaptation and the personality factor "openness" were stronger contributors to suicidal ideation among prior attempters while anxiety and extraversion appeared protective against ideation. Among nonattempters, depression, anxiety, and neuroticism were the predominant influences on suicidal ideation. Bipolar patients with suicidal ideation may benefit from different treatment strategies depending on their prior attempt status.     

The predictive validity of the Zung Index of Potential Suicide

Examined the predictive validity of the Zung Index of Potential Suicide. Subjects hospitalized for a suicide attempt were followed up 6 months later. In agreement with earlier studies, the IPS clinical scale was related to suicidal ideation and prior attempting at the time of admission. However, it was not related to further suicidal behavior or ideation at the 6-month followup. It is concluded that the scale lacks predictive validity and its use for assigning suicidal risk is not justified.