Impact of Firearm Availability and Gun Regulation on State Suicide Rates

Past studies on suicide have investigated the association of firearm ownership and suicide risk in the United States. The aim of the present study was to build on previous work by examining the impact of firearm storage practices and the strictness of firearm regulation on suicide rates at the state level. Data were compiled from primarily three sources. Suicide and firearm ownership information was obtained from the Centers for Disease Control and Prevention. Strictness of handgun regulation was derived from figures available at the Law Center to Prevent Violence, and controls were taken from the US Bureau of the Census. Mixed models were fitted to the data. Household firearm ownership was strongly associated with both suicide by all mechanisms, and firearm suicide. Storage practices had especially elevated consequences on suicide rates. Percent with loaded guns and gun readiness increased suicide rates, and strictness of gun regulation reduced suicide rates. Ready access to firearms can make a difference between life and death. Loaded and unlocked firearms within reach become risk factors for fatal outcomes from suicidal behavior. Future research might want to examine ways of obtaining more recent data on individual firearm ownership. This study proposes several policy recommendations for suicide prevention.     

Risk for Suicidal Ideation and Attempt among a Primary Care Sample of Adolescents Engaging in Nonsuicidal Self‐Injury

One in five adolescents in the United States has engaged in nonsuicidal self‐injury (NSSI), one in eight have had serious thoughts of suicide, and one in 25 have attempted suicide. Research suggests that NSSI may increase risk for suicide attempt, yet little is known about the relationship between NSSI and suicidal ideation or attempts. In a primary care setting, 1,561 youth aged 14–24 years completed a brief, comprehensive, mental health screen as part of a routine well visit to determine which factors were most likely to predict suicidal ideation and attempt among youth engaging in NSSI. Results of recursive partitioning revealed that current depression and history of alcohol use best differentiated youth engaging in NSSI with low versus high risk for suicidal ideation and attempts. This simple algorithm is presented as a clinical screening tool that might aid medical providers in determining which youth would benefit from more intensive assessment and intervention.     

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.     

Suicidal behavior and firearm access: results from the second injury control and risk survey

The association between home firearms and the likelihood and nature of suicidal thoughts and plans was examined using the Second Injury Control and Risk Survey, a 2001-2003 representative telephone survey of U.S. households. Of 9,483 respondents, 7.4% reported past-year suicidal thoughts, 21.3% with a plan. Similar proportions of those with and without a home firearm reported suicidal thoughts, plans, and attempts. Among respondents with suicidal plans, the odds of reporting a plan involving a firearm were over seven times greater among those with firearms at home, compared with those without firearms at home. The results suggest people with home firearms may not be more likely to be suicidal, but when suicidal they may be more likely to plan suicide by firearm.     

Empirically Derived Subgroups of Self‐Injurious Thoughts and Behavior: Application of Latent Class Analysis

Latent class analysis was applied to the sample data to identify homogenous subtypes or classes of self‐injurious thoughts and behavior (SITB) based on indicators indexing suicide ideation, suicide gesture, suicide attempt, thoughts of nonsuicidal self‐injury (NSSI), and NSSI behavior. Analyses were based on a sample of 1,809 healthy adults. Associations between the emergent latent classes and demographic, psychological, and clinical characteristics were assessed. Two clinically relevant subtypes were identified, in addition to a class who reported few SITBs, and were labeled as follows: low SITBs (25.8%), NSSI and ideation (25%), and suicidal behavior (29.2%). Several unique differences between the latent classes and external measures emerged. For instance, those belonging to the NSSI and ideation class compared with the suicidal behavior class reported lower levels of entrapment, burdensomeness, fearlessness about death, exposure to the attempted suicide or self‐injury of family members and close friends, and higher levels of goal disengagement and acute agitation. SITBs are best explained by three homogenous subgroups that display quantitative and qualitative differences. Profiling the behavioral and cognitive components of suicidal and nonsuicidal self‐injury is potentially useful as a first step in developing tailored intervention and treatment programs.     

Sequelae of Aggression in Acutely Suicidal Adolescents

The consequences of aggression on problem course and suicide risk were examined in 270 acutely suicidal adolescents (ages 12-17 years; 184 girls). Participants were assessed during psychiatric hospitalization (T1), 6-months post-hospitalization (T2), and 15 or more months post-hospitalization (T3). Study variables included self- and parent-reported aggression; self-reported internalizing symptoms, suicidal ideation, suicide attempt, and adverse events; and clinician-rated suicidal behavior. Aggression was not directly related to suicide attempt concurrently or prospectively. However, among more aggressive youth, internalizing symptoms were more predictive of T3 suicide attempt than among less aggressive youth. T1 aggression predicted aggressive incidents and the likelihood of incarceration prior to T3. Two-level hierarchical linear modeling indicated that self-reported aggression and internalizing problems were linked in terms of severity and rates of decline over time. Overall, parent-reported aggression was negatively associated with suicidal ideation. Findings highlight (a) the continuity and consequences of aggression, (b) a possible role of aggression in worsening suicide risk factors and potentiating suicide attempt, and (c) the importance of ongoing research on subtypes of suicidal adolescents.     

厌恶情绪与自杀行为的关系

自杀导致人类死亡的人数与日俱增,然而自杀的心理机制却并不清楚。最近研究发现,厌恶情绪是导致自杀的主要情绪因素,个体因为自身厌恶而走向自杀。厌恶情绪是一种对自己和他人排泄物等反感的基本情绪,促进个体远离毒性和疾病,从而产生“免疫行为”。许多心理问题来自于对周围人或事物的厌恶,有自杀行为的个体对自身极其厌恶,说明他们的厌恶情绪出现了问题。如同躯体免疫攻击自身一样,自身厌恶是自杀意念的关键因素,早年创伤是其根源,生活压力和精神疾病也参与厌恶诱发自杀意念。厌恶诱发自杀意念的神经基础与HPA轴和五羟色胺系统有关。未来研究可利用神经影像和电生理等神经科学技术,检验自杀行为的神经机制,探讨厌恶情绪影响自杀行为的心理和神经机制。     

Six year follow-up of health status changes in Danish adults with suicide tendency in 1994

The purpose of this study was to determine whether suicidal ideation and/ or suicide attempts have any long-term health effects. The relationship between suicidal thoughts and/or a previous suicide attempt in 1994 and the presence of suicidal ideation in 2000 was analyzed. We found that health status in 1994 differed significantly between the groups with and without suicidal ideation or a previous suicide attempt and that the differences persisted or even deepened (not significant) after 6 years. Further, people who had suicidal ideation or a suicide attempt in 1994 had a significantly greater risk (OR = 7.4) of having suicidal ideation in 2000 than people who had not.     

Firearm Storage Practices and Risk Perceptions Among a Nationally Representative Sample of U.S. Veterans With and Without Self‐Harm Risk Factors

Despite the disproportionate use of firearms in Veteran suicides and the well‐established link between firearm access and suicide, little is known about how Veterans store their firearms or what they think about the relationship between firearm access and suicide risk. Using data from 2015 nationally representative online survey (response rate 60.9%), we compare characteristics of Veteran firearm owners with and without self‐harm risk factors with respect to how they store their firearms and their beliefs about suicide risk related to firearms. Overall, one in three U.S. Veteran firearm owners store household firearms loaded and unlocked, one in twenty believe that a firearm increases household suicide risk, and one in four consider their loaded and unlocked firearm to be inaccessible to suicidal household members. Storage practices and risk perceptions are similar among those with and without self‐reported suicide risk factors. Affecting risk perceptions may be a critical aspect of interventions addressing lethal means safety among U.S. Veterans.     

Suicidal Ideation of Psychiatrically Hospitalized Adolescents has One-Year Predictive Validity for Suicide Attempts in Girls Only

Clinicians commonly incorporate adolescents’ self-reported suicidal ideation into formulations regarding adolescents’ risk for suicide. Data are limited, however, regarding the extent to which adolescent boys’ and girls’ reports of suicidal ideation have clinically significant predictive validity in terms of subsequent suicidal behavior. This study examined psychiatrically hospitalized adolescent boys’ and girls’ self-reported suicidal ideation as a predictor of suicide attempts during the first year following hospitalization. A total of 354 adolescents (97 boys; 257 girls; ages 13–17 years) hospitalized for acute suicide risk were evaluated at the time of hospitalization as well as 3, 6, and 12 months later. Study measures included the Suicidal Ideation Questionnaire-Junior, Multidimensional Anxiety Scale for Children, Children’s Depression Rating Scale-Revised, Beck Hopelessness Scale, Youth Self-Report, and Personal Experiences Screen Questionnaire. The main study outcome was presence and number of suicide attempt(s) in the year after hospitalization, measured by the Diagnostic Interview Schedule for Children. Results indicated a significant interaction between suicidal ideation, assessed during first week of hospitalization, and gender for the prediction of subsequent suicide attempts. Suicidal ideation was a significant predictor of subsequent suicide attempts for girls, but not boys. Baseline history of multiple suicide attempts was a significant predictor of subsequent suicide attempts across genders. Results support the importance of empirically validating suicide risk assessment strategies separately for adolescent boys and girls. Among adolescent boys who have been hospitalized due to acute suicide risk, low levels of self-reported suicidal ideation may not be indicative of low risk for suicidal behavior following hospitalization.     

Marital Discord and Suicidal Outcomes in a National Sample of Married Individuals

Suicide is the tenth leading cause of death in the United States, with an average of 105 suicides committed daily. The association between marital discord and 12‐month prevalence of suicidal ideation and suicide attempt was studied in a population‐based sample of married adults (N = 1,384). Marital discord was significantly and positively associated with suicidal ideation and suicide attempt, and these associations remained significant when controlling for demographics and 12‐month prevalence of mood, anxiety, and substance use disorders. Results suggest that marital discord is an important correlate of suicidal outcomes and may be important to target in preventing and treating suicide.     

A Suicide Prevention Campaign for Firearm Dealers in New Hampshire

A spate of suicides involving a just‐purchased firearm led a statewide coalition of firearm dealers, firearm rights advocates, and suicide prevention professionals to discuss the role of gun shops in preventing suicide. The group developed and mailed materials for (1) firearm retailers on avoiding sales to suicidal customers and (2) their customers on suicide and firearm safety. All storefront retailers were identified (n = 65), visited unannounced 6 months after receiving materials, and asked to complete a survey. Nearly half (48%) had at least one campaign product on display. Belief that reducing a suicidal person's access to firearms might save a life was associated with displaying materials (69% vs. 41%, p = .06). Public health and gun groups can successfully collaborate on suicide prevention activities.     

The Moderating Effects of Gratitude on the Association Between Perceived Parenting Styles and Suicidal Ideation

Suicidal ideation is defined as the thoughts about engaging in suicidal-related behaviors. Very few studies have been conducted on children’s suicidal ideation as there is a biased perception that suicidal behavior under the age of 12 is scarce. However, suicide is the leading cause of death among young children. Child suicidal ideation is predictive of suicidal ideation and suicide attempts in adulthood. Association between certain parenting styles and suicidal ideation have been found in empirical studies. However, little is known about the role of parenting and suicidal ideation in Chinese young children. We examined whether gratitude can reduce the risk of suicide by moderating the association between parenting styles and child suicidal ideation. We recruited 447 Chinese children (53.3% female; mean age?=?10.06, SD?=?1.76) to participate in a survey. Perceived parenting style (warmth/accepting, dominating, and autonomy granting), gratitude, and suicidal ideation were assessed using self-reported measures. We found that all three perceived parental styles were significantly associated with child suicidal ideation. Further, gratitude was found to have a significant moderating effect on suicidal ideation, across the analysis of the three perceived parenting styles. This suggests that gratitude may be adopted in preventive and clinical interventions so that children at risk can benefit from reducing the negative effects of ineffective parenting styles and suicidal ideation.     

Preliminary Validation of a Korean Version of the Acquired Capability for Suicide Scale‐Fearlessness About Death

The interpersonal‐psychological theory of suicide proposes that the desire for suicide must be accompanied by the capability to do so in order for an individual to engage in suicidal behavior. The Acquired Capability for Suicide Scale‐Fearlessness about Death (ACSS ‐FAD ) measures fearlessness about death, a core component of the capability for suicide. This study aimed to validate a Korean version of the ACSS ‐FAD in a college student sample. We administered the ACSS ‐FAD and measures of suicide ideation, fear of suicide, death anxiety, pain anxiety, and depression in a sample of Korean college students (N  = 301) and analyzed its reliability, factor structure, invariance across genders, convergent validity, and discriminant validity. The one‐factor model achieved satisfactory model fit. Across genders, partial metric invariance and partial scalar invariance were established. The results also revealed that the ACSS ‐FAD has good internal consistency, convergent validity (positive correlations with fear of suicide, death anxiety, and pain anxiety), and discriminant validity (no relation with depression). The Korean version of the ACSS ‐FAD presents adequate psychometric properties and may be considered to be a promising instrument for measuring fearlessness about death in college students.     

Youth suicide: insights from 5 years of Arizona Child Fatality Review Team data

Data on 153 youth suicides in Arizona (1994-1999) were used to explore demographic, behavioral, and experiential factors that distinguish between firearm suicide and suicide by other means. In bivariate analyses, White youths were more likely than non-White youths to use a firearm to commit suicide as were youths who had not experienced a life crisis or expressed suicidal thoughts in the past, relationships that hold in multivariate analyses at the p < 0.2 level. Targeted suicide prevention activities should supplement interventions focused on restricting access to highly lethal means of suicide such as firearms.     

Association of solitary binge drinking and suicidal behavior among emerging adult college students

[Correction Notice: An Erratum for this article was reported in Vol 26(3) of Psychology of Addictive Behaviors (see record 2012-13892-001). In the article, there is an error in the introductory paragraph. The number of students who had seriously considered attempting suicide in the Barrios, Everett, Simon, & Brener (2000) study should have been reported as 11.4%, not 1.4%. Additionally, in the Participants section, data for the study were collected from March 2009 to September 2010, not March 2009 to January 2010 as reported.] Emerging adult college students who binge drink in solitary contexts (i.e., while alone) experience greater depression and suicidal ideation than do students who only binge drink in social contexts, suggesting that they may be at greater risk for suicidal behavior. This study examined the association of a previous suicide attempt, one of the best predictors of future suicide attempts and suicide, and severity of recent suicidal ideation with drinking in solitary and social contexts. Participants were binge drinking, emerging adult (18- to 25-year-old) college students (N = 182) drawn from two studies of college drinkers. A logistic regression analysis revealed that both suicide attempt history and severity of suicidal ideation were significantly associated with a greater likelihood of being a solitary binge drinker as opposed to only a social binge drinker. Students with a previous suicide attempt were nearly four times more likely to be solitary binge drinkers. Multiple regression analyses revealed that suicide attempt history was significantly associated with greater frequency and quantity of drinking in solitary, but not social contexts. Suicidal ideation was significantly associated with drinks per solitary drinking day, but not frequency of solitary drinking once suicide attempt history was accounted for. Given the associations found between solitary binge drinking and a history of suicide attempts, as well as greater severity of recent suicidal ideation, it appears that these students are in need of suicide prevention efforts, including treatment efforts aimed at reducing binge drinking. (PsycINFO Database Record (c) 2012 APA, all rights reserved).     

The relationship between posttraumatic stress symptomatology and suicidal behavior in school-based adolescents

This study investigated the relationship between posttraumatic stress disorder (PTSD) symptomatology and suicidal behavior, specifically suicidal ideation and suicide attempt history, while controlling for depression and gender in 106 adolescents in an urban high school. Participants completed self-report measures of the Adolescent Psychopathology Scales-Posttraumatic Stress Disorder Subscale (APS-PTS), the APS-Suicide Attempt History (APS-SAH), the Suicidal Ideation Questionnaire-Junior (SIQ-JR), and the Reynolds Adolescent Depression Scale (RADS). Analyses were conducted using a hierarchical multiple regression design to account for the relationship between PTSD symptomatology and depression. Regression results showed that after controlling for depression and gender, PTSD symptomatology was significantly related to suicidal ideation and showed a trend toward suicide attempt history. In addition, adolescents with high levels of PTSD symptomatology were more likely than peers with "average" levels of PTSD symptomatology to be currently thinking about suicide and to have made a past suicide attempt. These findings show that PTSD symptomatology has a unique relationship to adolescent suicidal behavior that cannot be explained by depression or gender. The importance of these results and their implications for future research are discussed.     

The Association Between Gun Ownership and Statewide Overall Suicide Rates

An extensive body of research has demonstrated an association between gun ownership and suicide that extends beyond the effects of a range of covariates. We aimed to expand on extant research by examining the extent to which gun ownership predicts statewide overall suicide rates beyond the effects of demographic, geographic, religious, psychopathological, and suicide‐related variables. By extending the list of covariates utilized, considering those covariates simultaneously, and using more recent data, we sought to present a more stringent test. Gun ownership predicted statewide overall suicide rates, with the full model accounting for more than 92% of the variance in statewide suicide rates. The correlation between firearm suicide rates and the overall suicide rate was significantly stronger than the correlation between nonfirearm suicide rates and the overall suicide rate. These findings support the notion that access to and familiarity with firearms serves as a robust risk factor for suicide. Therefore, means safety efforts aimed at reducing accessibility and increasing safe storage of firearms would likely have a dramatic impact on statewide overall suicide rates.     

Correction to gonzalez (2012)

Reports an error in "Association of solitary binge drinking and suicidal behavior among emerging adult college students" by Vivian M. Gonzalez (Psychology of Addictive Behaviors, Advanced Online Publication, Jan 30, 2012, np). In the article, there is an error in the introductory paragraph. The number of students who had seriously considered attempting suicide in the Barrios, Everett, Simon, & Brener (2000) study should have been reported as 11.4%, not 1.4%. Additionally, in the Participants section, data for the study were collected from March 2009 to September 2010, not March 2009 to January 2010 as reported. (The following abstract of the original article appeared in record 2012-02608-001.) Emerging adult college students who binge drink in solitary contexts (i.e., while alone) experience greater depression and suicidal ideation than do students who only binge drink in social contexts, suggesting that they may be at greater risk for suicidal behavior. This study examined the association of a previous suicide attempt, one of the best predictors of future suicide attempts and suicide, and severity of recent suicidal ideation with drinking in solitary and social contexts. Participants were binge drinking, emerging adult (18- to 25-year-old) college students (N = 182) drawn from two studies of college drinkers. A logistic regression analysis revealed that both suicide attempt history and severity of suicidal ideation were significantly associated with a greater likelihood of being a solitary binge drinker as opposed to only a social binge drinker. Students with a previous suicide attempt were nearly four times more likely to be solitary binge drinkers. Multiple regression analyses revealed that suicide attempt history was significantly associated with greater frequency and quantity of drinking in solitary, but not social contexts. Suicidal ideation was significantly associated with drinks per solitary drinking day, but not frequency of solitary drinking once suicide attempt history was accounted for. Given the associations found between solitary binge drinking and a history of suicide attempts, as well as greater severity of recent suicidal ideation, it appears that these students are in need of suicide prevention efforts, including treatment efforts aimed at reducing binge drinking. (PsycINFO Database Record (c) 2012 APA, all rights reserved).     

Trajectories of Suicide Ideation,Nonsuicidal Self‐Injury,and Suicide Attempts in a Nonclinical Sample of Military Personnel and Veterans

Nonsuicidal self‐injury (NSSI) is a risk factor for suicide attempts, but little is known about NSSI among military personnel and veterans, or about the temporal sequencing of NSSI relative to suicide ideation and attempts. This study evaluates trajectories of suicide ideation, NSSI, and suicide attempts in a sample of 422 military personnel and veterans. Of those with a history of NSSI, 77% also experienced suicide ideation. Suicide ideation emerged before NSSI (67%) more often than the reverse (17%). Of those with a history of suicide attempt, 41% also engaged in NSSI. NSSI emerged prior to the first suicide attempt (91%) more often than the reverse (9%). The length of time from suicide ideation to suicide attempt was longer for those who first engaged in NSSI (median = 3.5 years) compared with those who did not engage in NSSI (median = 0.0 years), Wald χ²(1) = 11.985, p = .002. Age of onset was earlier for participants reporting NSSI only compared with those reporting both NSSI and suicide attempts (16.71 vs. 22.08 years), F(1, 45) = 4.149, p = .048. NSSI may serve as a “stepping stone” from suicide ideation to attempts for 41% of those who attempt suicide.