Suicide planning among high school students who report attempting suicide

Using a nationally representative sample of 16,296 high school students, we examined those who reported attempting suicide but did not report a suicide plan in the past 12 months. Results from logistic regression analyses showed that the 15% of attempters who did not report planning were as likely to receive medical treatment after their attempt as the attempters who did report planning. They also were more likely than nonideators and less likely than attempters who reported planning to report substance use and weapon carrying. All attempters, regardless of planning, were at high risk for fighting. Additional effort is needed to understand and prevent unplanned suicide attempts.     

Detecting Suicide Risk Among College Students: A Test of the Predictive Validity of the Modified Emotional Stroop Task

Detecting suicide risk among nonclinical populations is challenging due to low base rates and the help‐negation tendency of at‐risk individuals. The current longitudinal study investigated the predictive validity of the modified emotional Stroop task (EST) by conducting a follow‐up study of 197 students who participated in a study by Chung and Jeglic (2016). The EST latencies for suicide‐related cues and past suicidal behaviors were the only significant predictors of suicide risk. The findings of this study provide preliminary support for the use of the EST as part of a suicide risk screening battery that could add to the detection of suicide risk.     

Nonlinear Change Processes During Psychotherapy Characterize Patients Who Have Made Multiple Suicide Attempts

Research suggests that multiple suicide attempters experience considerable variability in suicide ideation and longer‐duration suicidal crises, which suggests the possibility of two states of stability (one low risk and one high risk). To date, however, few studies have examined nonlinear change processes in suicide ideation among patients. In a sample of 76 active duty U.S. Army soldiers receiving brief cognitive behavioral therapy for acute suicide risk, we examined differences in the ebb and flow of suicide ideation among multiple attempters, first‐time attempters, and ideators. Results indicated that multiple attempters were characterized by two states of stability corresponding to low and high intensity suicide ideation; these states were separated by a region of instability corresponding to moderate intensity suicide ideation. In contrast, ideators and first‐time attempters were characterized by only a single state of stability corresponding to low intensity suicide ideation. Among patients who have made multiple suicide attempts, suicide ideation may function as a bimodal rather than a continuous construct.     

Clarifying the Relationship of Parental Bonding to Suicide Ideation and Attempts

Suicide and suicidal behavior are major public health problems, especially among adolescents and young adults. Previous research has established links between parental bonding and suicidality; however, it remains unclear whether parental bonding is associated with suicide ideation, the progression from suicide ideation to suicide attempts, or both. This study examined the relation of parental bonding to suicide ideation and suicide attempts in adolescents from two settings: (1) acute psychiatric care (n = 172) and (2) high school (n = 426). All participants were administered validated measures of parental bonding, suicide ideation, and suicide attempts, as well as emotion dysregulation, loneliness, and self‐worth. In the psychiatric sample, lower parental care significantly differentiated adolescents with a history of suicide attempts from those with suicide ideation only or without histories of suicidality. This pattern remained even after controlling for other known correlates of suicidality (i.e., emotional dysregulation, loneliness, and low self‐worth). Similar effects were found in the community sample, although these findings failed to reach statistical significance. In both samples, parental overprotection was not associated with suicide ideation or suicide attempts. Results suggest that parental care may be an important risk factor for youth suicidal behavior and may help differentiate suicide attempters from suicide ideators.     

Cognitive rigidity in suicide attempters

A number of investigators have reported evidence of cognitive rigidity in suicide attempters (e.g., Levenson & Neuringer, 1971; Neuringer, 1964; Patsiokas, Clum, & Luscomb, 1979). It is important to note, however, that in all of the studies that found suicide attempters to be rigid, the test batteries had been administered to persons during their period of hospitalization immediately following a suicide attempt-thus, presumably, while they were still in the crisis period. The present study was designed as a step toward determining whether cognitive rigidity is a personality trait of suicide attempters or simply a transient characteristic limited to the crisis period. We administered tests for rigidity to persons who had attempted suicide but were well past the crisis period. These persons were less rigid than attempters from previous studies on the Rokeach Map Test (p less than .05) and the Alternate Uses Test (p less than .001). The implication is that if indeed there is a suicidal personality, rigidity is not a defining trait.     

Rethinking impulsivity in suicide

Elevated impulsivity is thought to facilitate the transition from suicidal thoughts to suicidal behavior. Therefore, impulsivity should distinguish those who have attempted suicide (attempters) from those who have only considered suicide (ideators-only). This hypothesis was examined in three large nonclinical samples: (1) 2,011 military recruits, (2) 1,296 college students, and (3) 399 high school students. In sample 1, contrary to traditional models of suicide risk, a unidimensional measure of impulsivity failed to distinguish attempters from ideators-only. In samples 2 and 3, which were administered a multidimensional measure of impulsivity (i.e., the UPPS impulsive behavior scale; Whiteside & Lynam, 2001), different impulsivity-related traits characterized attempters and ideators-only. Whereas both attempters and ideators-only exhibited high urgency (the tendency to act impulsive in the face of negative emotions), only attempters exhibited poor premeditation (a diminished ability to think through the consequences of one's actions). Neither attempters nor ideators-only exhibited high sensation seeking or lack of perseverance. Future research should continue to distinguish impulsivity-related traits that predict suicide ideation from those that predict suicide attempts, and models of suicide risk should be revised accordingly.     

Interoceptive Deficits,Nonsuicidal Self‐Injury,and Suicide Attempts Among Women with Eating Disorders

People with eating disorders (ED s) have an elevated risk for both nonsuicidal self‐injury (NSSI ) and suicide compared to the general population. This study tests two theoretically derived models examining interoceptive deficits as a risk factor for NSSI , and examining interoceptive deficits, NSSI , fearlessness about death, and pain tolerance as risk factors for suicide. Ninety‐six adult, treatment‐seeking women with ED s completed self‐report questionnaires at a single time point. Interoceptive deficits were significantly associated with NSSI , and NSSI was in turn associated with both pain tolerance and fearlessness about death. Further, pain tolerance was in turn associated with past suicide attempts, although fearlessness about death was not associated with suicide attempts. Interoceptive deficits had a direct association with fearlessness about death but not pain tolerance. Results regarding the relation between interoceptive deficits and suicide attempts were mixed, yet overall suggest that interoceptive deficits are related to suicide attempts largely indirectly, through the effects of mediating variables such as NSSI , fearlessness about death, and pain tolerance. Results suggest that interoceptive deficits and pain tolerance merit further investigation as potential risk factors for fatal and nonfatal self‐harm among individuals with ED s.     

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.     

Childhood physical and sexual abuse in depressed patients with single and multiple suicide attempts

Research has shown both childhood physical and sexual abuse to be associated with later suicide attempts, although some studies have not supported these findings. However, few studies have investigated differences in physical and sexual abuse histories among single and multiple suicide attempters. The goals of the current study were two-fold: (a) to replicate previous findings of associations between childhood sexual and physical abuse and suicide attempts, and (b) to explore differences in reports of childhood physical and sexual abuse among single and multiple suicide attempters. While our results supported the findings that individuals with a history of suicide attempts are more likely to report histories of childhood physical and sexual abuse, we did not find a difference in reported abuse between single and multiple suicide attempters. Implications of these findings, as well as implications for future research, are discussed.     

Suicide Attempts in Preadolescent Child Psychiatry Inpatients

This paper describes a preliminary study examining the relative power of measures of perceived family support, hopelessness, and depression for the classification of suicide attempters and nonattempters in a series of 8- to 13-year-old psychiatric inpatients. Results of a stepwise discriminant-function analysis indicated that a measure of a child's perceived family support discriminated between suicide attempters and nonattempters with an 88% accuracy rate. The addition of measures of hopelessness and depression at later steps did not lead to improved classification. The results are interpreted as providing strong support for a link between suicide attempts in children and perceptions of low family support.     

The Suicidal Inmate: A Comparison of Inmates Who Attempt Versus Complete Suicide

The aim of this study was to identify risk factors distinguishing inmates who attempt suicide from inmates who complete suicide. Compared with attempters, completers tended to be older, male, more educated, and married or separated/divorced; pretrial, committed for a violent crime, incarcerated in jail, housed in an inpatient mental health unit or protective custody setting, living in a single cell, not on suicide precautions, not previously under close observation; and more likely to act during overnight hours and die by hanging/self‐strangulation. Targeted assessment of a broad range of risk factors is necessary to inform suicide prevention efforts in correctional facilities.     

Do Traditional Admissions Criteria Reflect Applicant Creativity?

College admissions decisions have traditionally focused on high school academic performance and standardized test scores. An ongoing debate is the validity of these measures for predicting success in college; part of this debate includes how success is defined. One potential way of defining college success is a student's creative accomplishments. We tested the hypothesis that traditional admissions criteria fail to capture adequately the creativity of applicants by asking 610 college applicants to complete several creativity tasks. These included divergent thinking, caption‐writing, an essay, and self‐report measures of creativity in numerous domains. Creativity scores were compared to data from the college application, including high school rank, standardized test scores, and admissions interview scores. Results showed that traditional admissions criteria were only weakly related to creativity. Indeed, students who report the highest creative self‐efficacy can be perceived as weaker applicants according to traditional criteria. Findings are discussed in light of the goals of higher education to increase diversity of the student body and the abilities of its students.     

Suicide attempts in runaway youths

This study explored suicidal behavior in 291 adolescents who were using runaway shelters in St. Louis. Thirty percent of the runaways reported having attempted suicide in the past. The suicide attempters had significantly more behavioral and mental health problems, and reported having more family members and more friends with problems, than nonattempters. A logistic regression showed that youths' substance use, behavior problems, family instability, and sex all helped to explain their suicide attempts. Most of the attempters made their first attempt by their midteens. One-quarter made their latest attempt shortly before entering the shelter, and one-fifth stated that they would still consider suicide. The great majority of attempts were not preplanned, but one-third followed troubles or arguments at home and feelings of confusion and depression. Remarkably, half of the teenage suicide attempters never received any professional help following their attempt.     

Factors Associated with the Medical Severity of Suicide Attempts in Youths and Young Adults

T his study examined factors associated with the medical severity of suicide attempts focusing on demographic characteristics, mental health characteristics, and the circumstances of the suicide attempt. Analyses were based on 153 nearly lethal suicide attempters and 47 less lethal suicide attempters aged 13–34 years who presented to emergency departments in Houston, Texas. The results show that young age was significantly associated with a nearly lethal suicide attempt. Prior suicide attempts, hopelessness, depression, and help‐seeking (ever) were significantly and negatively associated with a nearly lethal suicide attempt. None of the suicide attempt factors occurring prior to the attempt were associated with a nearly lethal suicide attempt.     

Psychopathology associated with suicide attempts among rural adolescents of China

This case control study examined the relationship between psychopathological profiles and self-reported suicide attempts among rural adolescents of China. Cases consisted of 142 adolescents who reported a suicide attempt in the past 6 months in a questionnaire survey (n=1365). An equal number of adolescents without reporting a suicide attempt, matched on age, gender, and school class, were selected from the same survey sample as controls. The Youth Self Report (YSR) was used to assess psychopathological profiles for suicide attempters and matched controls. Results indicated that 73% of suicide attempters had at least one behavioral/emotional syndrome, significantly higher than in controls (30%). Logistic regression analyses showed that anxiety/depression (OR = 3.68) and aggression (OR = 5.02) were each significantly associated with increased risk of suicide attempts after controlling for other behavioral problems. These findings demonstrated the independent contribution of anxiety/depression and aggression to suicide attempts in Chinese adolescents.     

Similarities and Differences in Precipitating Events Between Black and Anglo Suicide Attempts

ABSTRACT: The rapid rise in suicide among young Blacks in America the past decade is of increasing concern to mental health practitioners and suicidologists. While there are some similarities among suicide attempts by Blacks and Whites, the pattern is that Black suicide attempters are distinctly more youthful. This exploratory study tests the hypothesis that the precipitating events for young Blacks who consider, plan, and attempt suicide is more likely to be “the loss or threatened loss of a love partner in the context of a negative value-orientation and intragroup pressures” than among Anglo suicide attempters. Specific strategies are recommended that use a family perspective for assisting Blacks who consider, plan and attempt suicide.     

Sociodemographic and Clinical Differences Between Suicide Ideators and Attempters: A Study of Mood Disordered Patients 50 Years and Older

Our study sought to characterize mood disordered suicide ideators and attempters 50 years and older admitted to a psychiatric ward either for a recent suicide attempt or for ongoing suicidal ideation. We enrolled 50 patients with suicide ideation consecutively admitted to an inpatient department and 50 patients admitted for a suicide attempt made in the last 48 hours. Suicide attempters more frequently had low social support and an age of onset of mood disorder of 46 years and older, and less frequently had a history of suicidal behaviors in the family members and pharmacological treatment, despite the fact that the groups did not differ with regard to antidepressants prescribed. The groups were not distinguishable based on several variables assumed to be risk factors for suicide behavior, such as proximal life events and stressors or alcohol use disorders. In both samples, comorbidity with organic diseases, the presence of stressful life events in the past 12 months, and a diagnosis of major depression were frequently reported. In conclusion, the presence of low social support and the absence of a pharmacotherapy may increase suicidal behaviors in patients at risk.     

THE DEPENDENCY NEEDS AND PERCEIVED AVAILABILITY AND ADEQUACY OF RELATIONSHIPS IN FEMALE ADOLESCENT SUICIDE ATTEMPTERS

Traditional theories about female adolescent suicide attempters view them as experiencing difficulty in achieving adequate separation-individuation. However, recent work on female adolescence suggests that achieving greater interdependency within relationships rather than increased independence from them is an important goal for nonclinical nonsuicidal female adolescents. We investigated both dependency needs and the perceived availability and adequacy of relationships in 21 female adolescent attempters and 23 nonattempters. Dependency needs did not significantly differentiate suicide attempters from nonattempters. Attempters, however, did report both a smaller social network and fewer intimate relationships than nonattempters, as well as less satisfaction with these relationships. These preliminary results suggest that more research is required to establish whether dependency needs are indeed causally related to the female adolescents' suicide attempts. Future research should also investigate other risk factors such as relational dissatisfaction, familial suicide attempts, and abuse.     

Suicidal Self‐Directed Violence Among Homeless US Veterans: A Systematic Review

A systematic review of the literature was conducted to investigate suicidal self‐directed violence and homelessness among US military veterans, and identify existing suicide prevention strategies. In November 2015, MEDLINE, EMBASE, PsycInfo, CINAHL, Web of Science, Cochrane Library, Google, and Google Scholar were searched. Articles published since 1990 investigating self‐directed violence among homeless veterans were identified. Data were extracted and synthesized qualitatively. Nineteen observational studies were included. Suicide ideation rates were 1.3% (current), 7.0% (past week), 12.1%–18% (past 30 days), and 74% (lifetime). Suicide attempt rates were 0%–6% (past 30 days), 30.7%–31.5% (past 5 years), and 15%–46.6% (lifetime). Death by suicide rate was 81.0 per 100,000. No interventional studies to prevent self‐directed violence among homeless veterans were identified. Homeless veterans are at risk for self‐directed violence, suggesting the need for research to examine preventive strategies. A comprehensive public health approach to suicide prevention needs to focus on vulnerable populations, including homeless veterans.     

The Longitudinal Association of Being Bullied and Gender with Suicide Ideations,Self‐Harm,and Suicide Attempts from Adolescence to Young Adulthood: A Cohort Study

Longitudinal associations between being bullied during adolescence and suicide ideations, self‐harm, and suicide attempts into young adulthood were examined. A large representative sample was examined in 1998 (N  = 2,464, MA 13.7), 1999/2000, and 2012 to reassess the outcome measures. At all ages, bullied participants showed more suicide ideation, self‐harm, and suicide attempts, regardless of gender. Bullied females showed a decrease in suicide ideation from adolescence to adulthood, while bullied males showed an increase in suicide attempts in the same time period. Being bullied in adolescence strongly predicts suicidal behavior and self‐harm. Preventive efforts might reduce the risk of later suicidality.