Affective instability and suicidal ideation and behavior in patients with borderline personality disorder

This study employed an Experience Sampling Methodology (ESM) to test whether various elements of affective instability can predict future suicide ideation in patients with borderline personality disorder (BPD) and a history of recurrent suicidal behavior. Eighty-two individuals with BPD and a history of recurrent suicidal behavior were followed prospectively for one month during which time they recorded their current mood states, 6 times daily over three weeks. Accounting for a set of robust suicide risk factors in multiple regression analyses, only negative mood intensity was significantly related to intensity of self-reported suicide ideation and to number of suicidal behaviors over the past year. Other elements of affective instability examined (e.g., mood amplitude, dyscontrol, and reactivity) were not associated with future suicide ideation or with recent suicidal behavior. Affective instability in patients with BPD is highly variable from one individual to another and is characterized by high levels of intense negative mood. These negative mood states, versus other aspects of mood variability, seem to be more closely tied to the occurrence of suicidal ideation and behavior.     

Suicide Ideation in Adolescents Following Inpatient Hospitalization: Examination of Intensity and Lability Over 6 Months

Understanding suicide ideation (SI) in adolescents, especially during the high‐risk time following hospitalization for a suicidal event, is a crucial component of improving risk assessment. Most studies rely on single assessments of SI, despite the potential for SI to vary considerably over time. This study examined how indices of SI intensity (mean values) and lability (mean squared successive difference values) over a 6‐month period predict suicide attempts (SAs) and self‐harm, as well as how they relate to psychosocial risk factors and affective functioning, in a sample of 103 adolescents hospitalized for a SA or significant SI. Across the sample, SI intensity, but not lability, was associated with SAs and nonsuicidal self‐injury at 6‐month follow‐up. SI intensity performed similarly to single time point SI assessments, and its relations were not moderated by SI lability. SI intensity was also associated with borderline personality disorder criteria and a history of sexual abuse. In contrast, SI lability was associated with greater negative affect intensity and lability. These findings suggest that intensity of SI may confer more risk posthospitalization, and provide support for using these statistical methods to capture two distinct parameters of SI.     

Differentiating Adolescent Suicide Attempters from Ideators: Examining the Interaction between Depression Severity and Alcohol Use

Depressed mood, frequency of alcohol use, and their combination were examined to see if they differentiated nonsuicidal adolescents from those with suicidal ideation and adolescents with suicidal ideation from those who have made a suicide attempt. Hierarchical logistic regressions indicated that frequency of alcohol use did not differentiate nonsuicidal adolescents from those with current suicidal ideation, but severity of depressed mood did so. In contrast, alcohol use was a significant differentiating factor between adolescents who had attempted suicide compared to those with suicidal ideation only, with severity of depressed mood not being significant. However, there was also a significant interaction effect such that for adolescents with suicidal ideation and low levels of depression, increased frequency of alcohol use was associated with increased odds of a suicide attempt. These findings suggest that alcohol use may hasten the transition from suicidal ideation to suicide attempt in adolescents with low levels of depressed mood.     

Neuroticism,rumination, depression and suicidal ideation: A moderated serial mediation model across four countries

Background/objectiveResearch has highlighted the role of neuroticism, rumination, and depression in predicting suicidal thoughts, but studies on how these variables interplay are scarce. The aims of the present study were to test a model in which emotional stability (i.e., low neuroticism) would act as an antecedent and moderator of rumination and depressed mood in the prediction of suicidal ideation (i.e., moderated serial-mediation), and to explore their replicability across four countries and sex, among college students as an at-risk-group for suicide.MethodParticipants were 3482 undergraduates from U.S, Spain, Argentina, and the Netherlands. Path analysis and multi-group analysis were conducted.ResultsEmotional stability was indirectly linked to suicidal ideation via rumination and depressed mood. Moreover, emotional stability moderated the associations between rumination and depressed mood, and between depressed mood and suicidal ideation. Findings were consistent in males and females, and across countries studied.DiscussionRegardless of sex and country, people with low emotional stability reported higher levels of rumination, which in turn was associated with more depressed mood, and these were associated with higher reports of suicidal thoughts. This cascade of psychological risk factors for suicidal ideation seems to be more harmful in people who endorse low levels of emotional stability.     

A comparison of retrospective self-report versus ecological momentary assessment measures of affective lability in the examination of its relationship with bulimic symptomatology

Affective lability has been linked to several maladaptive behaviors ( [Anestis et?al., 2009] and [Coccaro, 1991]). Methodology for measuring affective lability varies and includes retrospective self-report and ecological momentary assessment (EMA). In this study, we sought to test these methodologies by examining which better predicted binge eating episodes and general eating disorder symptoms in a sample (n = 131) of women diagnosed with bulimia nervosa (BN). We hypothesized that, while the two forms of measurement would be correlated with one another and predict binge eating episodes, EMA affective lability would be the stronger predictor. Results supported several hypotheses. Specifically, both EMA affective lability and retrospective self-report affective lability significantly predicted global eating disorder symptoms, even when controlling for depression, age, body mass index, and level of education, EMA affective lability exhibited a significantly stronger correlation with binge eating episodes than did retrospective self-report affective lability, and EMA affective lability predicted number of binge eating episodes on any given day controlling for the same list of covariates. Limitations include the use of a clinical sample that may limit the generalizability of our findings. Findings highlight the importance of affect in such behavior.     

Externalizing problems,internalizing problems,and suicidal ideation in Singaporean adolescents: Sex differences

Adolescent suicide is considered a worldwide problem and an increasing source of concern in Singapore. This study explores the relationships among four factors of maladjustment (that is, emotional distress, negative self, antisocial behavior, and anger control problems) and suicidal ideation in two hundred and seventy-one adolescents from Singapore. Findings from the study indicated that emotional distress, negative self-concept, and antisocial behavior significantly predicted suicidal ideation for the whole sample. Beta weight is largest for emotional distress, followed by negative self, and then antisocial behavior. For females, only emotional distress significantly predicted suicidal ideation. Implications of these findings with regard to working with adolescents with suicidal ideations are discussed. Funding for this research is facilitated by grant RP 1/01 APH.     

Examining Youth Anxiety Symptoms and Suicidal Ideation in the Context of the Tripartite Model of Emotion

This study sought to clarify the relation of anxiety symptoms and suicidal ideation in children and adolescents by examining these variables in the context of depression and negative affect. As outlined in the tripartite model of anxiety and depression, negative affectivity is common to both emotional constructs; therefore negative affectivity may best explain the relation of each to suicidal ideation. Self report measures of generalized anxiety, depression, negative affectivity, and suicidal ideation were assessed in a primarily externalizing sample of children ages 7–18. Results suggested that the relation between anxiety and suicidal ideation was best accounted for by depression, not negative affectivity. Results also suggested that negative affectivity was associated with suicidal ideation but did not account for the relations among anxiety, depression, and suicidal ideation. Further, depression, negative affect, and anxiety all significantly contributed to the prediction of suicidal ideation scores (r ²  = .307, p < .01).     

The Relations of Temperament and Emotion Self-regulation with Suicidal Behaviors in a Clinical Sample of Depressed Children in Hungary

Although major depressive disorder (MDD) is associated with suicidal behaviors, some depressed individuals are not suicidal and others evidence various forms of suicidality. We thus investigated whether aspects of temperament and self-regulation of dysphoria represent risk factors for DSM-IV suicidality (recurrent thoughts of death, recurrent suicidal ideation, suicidal plan, and suicide attempt) in depressed youths. Using a sample of children with MDD (N = 407; ages 7-14 years), recruited from clinical sites across Hungary, we tested the hypotheses that: (a) suicidality is related to higher levels of trait negative emotionality as well as more maladaptive and fewer adaptive regulatory responses to dysphoria and (b) as the severity of suicidal behavior increases, levels of trait negative emotionality and dysfunctional emotion regulation also increase. We also explored if other aspects of temperament relate to suicidality. Children's DSM-IV diagnoses were based on semi-structured interviews and best-estimate psychiatric consensus. Parents independently provided ratings of their children's temperament, and children separately completed an inventory of emotion regulation (ER). Using multivariate models, we failed to confirm the hypothesized relations of negative trait emotionality and suicidality, but confirmed that high maladaptive and low adaptive ER response tendencies increase the odds of suicidal behaviors, above and beyond the risk posed by depressive illness severity. Unplanned interaction terms between temperament dimensions (other than negative emotionality) and ER suggested that at some high-extremes of temperament, ER has no impact on suicidality but in their absence, adaptive ER lowers the risk of suicidality. The practical implications of the findings are discussed.     

中国青少年父母教养方式与自杀意念的元分析

如何降低自杀意念是研究者共同面临的问题,其中家庭因素近些年得到了越来越多的关注。本研究采用元分析的方法考察中国青少年父母教养方式与自杀意念的关系及其影响因素,纳入了符合标准的文献22篇,包括158个效应量,总样本量为16980人。结果发现,父母积极教养方式与自杀意念呈显著负相关,父母消极教养方式与自杀意念呈显著正相关。年龄阶段、自杀意念测量工具能够显著调节父母教养方式与自杀意念的关系,独生子女比例能够调节父母消极教养方式与自杀意念的关系。上述结果表明,父母教养方式能够显著影响自杀意念,家长应采用情感温暖、理解等积极教养方式,而非拒绝、过度干涉等消极教养方式。     

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.     

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.     

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.     

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.     

Regulation of Negative Affect During Mother–Child Problem-Solving Interactions: Adolescent Depressive Status and Family Processes

Despite recent suggestions that depression can be conceptualized as a disorder of affect regulation, relatively little research has focused on affect regulation skills in depressed individuals. This paper investigated whether depressed adolescents (N = 25) differ from nondepressed adolescents (N 25) on two indices of affect regulation (i.e., duration of negative affective states and reciprocity of maternal negative affect) as well as whether these indices are related to microsocial family interactional processes. Analyses revealed that depressed teens differed from their nondepressed peers with regard to duration of negative affective states but not in their likelihood of reciprocating negative affect. Additionally, indices of adolescent affect regulation were related to family interactional processes. Duration of depressive affect was positively associated with maternal display of facilitative behavior contingent on adolescent depressive behavior. Duration of aggressive behavior was inversely related to maternal problem-solving responses to aggressive behavior. Finally, adolescent reciprocity of maternal depressive and aggressive behaviors was strongly associated with mothers' reciprocity of adolescents' negative affective behavior.     

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.     

Peer functioning, family dysfunction, and psychological symptoms in a risk factor model for adolescent inpatients' suicidal ideation severity

Examined models of suicidal ideation severity that include two psychosocial risk factors (i.e., peer and family functioning) and four domains of psychological symptoms (i.e., generalized anxiety, depression, conduct problems, and substance abuse/dependence). Participants were 96 psychiatric inpatients (32 boys, 64 girls), ages 12 to 17, who were hospitalized because of concerns of suicidality. Adolescents completed a structured diagnostic interview, measures of suicidal ideation, and several dimensions of family and peer functioning. Results supported a model in which greater levels of perceived peer rejection and lower levels of close friendship support were associated directly with more severe suicidal ideation. In addition, indirect pathways included deviant peer affiliation and global family dysfunction related to suicidal ideation via substance use and depression symptoms. The results are among the first to demonstrate relations between suicidal ideation and several areas of adolescent peer functioning, as well as divergent processes for peer and family predictors of suicidal ideation.     

The Functions of Social Support as Protective Factors for Suicidal Ideation in a Sample of Air Force Personnel

This study examined various functions of social support (i.e., tangible, esteem, belonging, and appraisal) were examined as protective factors for suicidal ideation in a sample of 273 active duty Air Force Security Forces personnel. Generalized linear regression analyses were conducted to determine if various social support functions were differentially associated with the presence and severity of suicidal ideation, both as main effects and as moderators of emotional distress. None of the four social support functions differentiated suicidal from nonsuicidal Airmen, but esteem support (i.e., feeling respected, encouraged, and valued by others) was associated with significantly less severe suicidal ideation (B = ?.074, SE = .025, p = .003). A significant interaction of tangible support (i.e., access to material resources) with emotional distress indicated that emotional distress was associated with more severe suicidal ideation only among Airmen reporting low levels of tangible support (B = .006, SE = .003, p = .018). When considered concurrently, both tangible and self‐esteem functions of social support are differentially associated with decreased suicidal ideation among Airmen, but belonging (i.e., having someone to do things with) and appraisal (i.e., having someone to talk to about problems) functions were not. Findings suggest that different aspects of social support affect suicidal ideation in different ways.     

Longitudinal Relationships Between Positive Affect,Loneliness, and Suicide Ideation: Age‐Specific Factors in a General Population

The aims of this study were to analyze whether positive and negative affect, social support, and loneliness are factors longitudinally related to suicide ideation in the general population in different age groups. A total of 2,392 individuals from a nationally representative sample of the Spanish general population were evaluated in 2011–2012 and in 2014–2015. After including relevant control variables in the analyses, lower positive affect was prospectively related to ideation in 18‐ to 59‐year‐old individuals, whereas feelings of loneliness were related to ideation in 60‐year‐and‐older individuals. Social support was not associated with suicide ideation in any age group. These results are in line with the need for age‐tailored suicide prevention programs. The present findings might also suggest that health care professionals should consider feelings of loneliness rather than social support to assess the presence of suicide ideation in older people.     

The Impact of Affective States and Affective Shifts on Creative Ideation and Evaluation

This study aims to examine the impact of affective states and affective shifts on ideation and evaluation of creativity. Affects were induced by a two‐stage imagination procedure of recalling autobiographical experiences. Three periods of divergent thinking were measured to represent the participants’ creative ideation at different times. Creative evaluation was measured by estimating the originality of each response provided by the participants. The results indicate that (a) during the initial period of ideation, groups with positive affect obtain better creative ideation than the groups with neutral or negative affect. (b) The ideation in positive affect groups gradually decreases over time, while the ideation in negative affect groups gradually increases over time. (c) During the evaluation of originality, groups with negative affect have a higher proportion of over‐estimates and a lower proportion of under‐estimates than groups with positive affect. The viewpoints of cognitive tuning theory, which posit that the affective state influences creativity, are supported.     

Family support,family stress,and suicidal ideation in a combat-exposed sample of Operation Enduring Freedom/Operation Iraqi Freedom veterans

Background and Objectives: Deployment-related risk factors for suicidal ideation among Operation Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF) veterans have received a great deal of attention. Studies show that mental health symptoms mediate the association between most deployment stressors and suicidal ideation; however, family-related factors during deployment are largely unexplored. We examined posttraumatic stress disorder (PTSD) and depression symptoms as mediators of the associations between deployment family support and stress and post-deployment suicidal ideation in combat-exposed OEF/OIF veterans. Design: National cross-sectional mail survey. Methods: 1046 veterans responded to the survey. The sample for this study was 978 veterans who experienced combat. Regression-based path analyses were conducted. Results: Family support and stress had direct associations with suicidal ideation. When PTSD and depression symptoms were examined as mediators of these associations, results revealed significant indirect paths through these symptoms. Conclusions: This study contributes to the literature on suicidal ideation risk factors among OEF/OIF veterans. Deployment family support and family stress are associated with suicidal ideation; however these associations occur primarily through mental health symptomatology, consistent with findings observed for other deployment factors. This research supports ongoing efforts to treat mental health symptomatology as a means of suicide prevention.