Positive mental health,positive affect and suicide ideation

Background/ObjectivePositive mental health (PMH) has been shown to confer resilience against suicide ideation. However, the mechanisms underlying the positive effect of PMH on suicide ideation/behavior are largely unknown. The current study aimed to determine whether positive affect mediates the association between PMH and suicide ideation.MethodA total of 150 adult outpatients (65.3%; female; age: M(SD)=37.79(13.50), range:18–77) completed measures on PMH, positive and negative affect, as well as suicide ideation. Data were collected using self-report questionnaires. Linear hierarchical regression analysis was used to analyze the data. Positive affect was considered to mediate the association between positive mental health and suicide ideation.ResultsWhile positive affect fully mediated the significant negative association between PMH and suicide ideation, negative affect did not reveal to be a significant mediator of this relationship.ConclusionsThe protective influence of PMH against suicide ideation is due to heightened positive affect: If positive mental health translates into positive affect, then suicide ideation becomes less likely.     

Perceived burdensomeness and suicide ideation in older adults

Older adults have the highest risk of death by suicide in the United States. Improving our understanding of the factors that lead to increased risk of suicide in older adults will greatly inform our ability to prevent suicide in this high-risk group. Two studies were conducted to test the effect of perceived burdensomeness, a component of the interpersonal-psychological theory of suicide (Joiner, 2005), on suicide ideation in older adults. Further, gender was examined as a moderator of this association to determine if perceived burdensomeness exerted a greater influence on suicide ideation in males. The results of these studies suggest that perceived burdensomeness accounts for significant variance in suicide ideation, even after predictors such as depressive symptoms, hopelessness, and functional impairment are controlled. Gender did not moderate the association. The implications of these findings for treatment of older adults with suicide ideation and elevated suicide risk are discussed.     

Positive and negative attitudes mediating suicide ideation.

Both the presence of negative expectancies (Beck, Weissman, Lester, & Trexler, 1974) and the absence of positive reasons for living (Linehan, Goodstein, Nielsen & Chiles, 1983) have been offered as partial explanations for why individuals consider suicide. The independent viability of these two explanations is evaluated in three studies that assess: (1) the distinctiveness of the nomological networks of measures of these two approaches; and (2) the latent variables that might account for any observed distinctiveness and for how two relatively independent constructs could both be related to suicide. Results obtained from both nonclinical and clinical samples consistently indicate distinct nomological nets for measures of "hopelessness" and "reasons for living." Results suggest that these measures are both related to suicide because measured suicide intent is a bi-factorial construct and measures of hopelessness and reasons for living are related to different underlying factors. Suicide intent is related to latent variables labelled "neuroticism" and "psychoticism;" hopelessness is related to these two factors and to "extraversion;" reasons for living is primarily related to psychoticism.     

Complicated grief and suicidal ideation in adult survivors of suicide

While the prevalence of complicated grief has been demonstrated to be elevated in survivors of suicide, the association between complicated grief and suicidal ideation among adult survivors of suicide has not been explored. The purpose of the present study is to examine the association between complicated grief and suicidal ideation in suicide survivors. The Inventory of Complicated Grief and the Beck Depression Inventory were administered to 60 adult survivors within 1 month of a death by suicide of a family member or significant other. Complicated grief was associated with a 9.68 (CI: 1.036, 90.417) times greater likelihood of suicidal ideation after controlling for depression, suggesting that syndromal complicated grief heightens vulnerability to suicidal ideation. Clinicians may provide more comprehensive assessments by recognizing the possibility of suicidal ideation in those with complicated grief.     

Positive affect and distressed affect over the day in older people

The purpose of this study was to assess patterns of affect over the day in a representative sample of older people, with particular emphasis on the impact of loneliness and depression. Momentary assessments of positive and distressed affect were obtained four times over a single day from 4,258 men and women aged 52-79 years from the English Longitudinal Study of Ageing. Positive and distressed affect were only modestly correlated (r = -0.23). Positive affect was low on waking and peaked in the early evening, while distressed affect decreased progressively over the day. The diurnal variation in positive affect was greater in participants <65 years compared with older individuals. Positive affect was greater in men, married participants and in healthy individuals, while distressed affect was higher among women, unmarried and lower socioeconomic status respondents, and in those with limiting longstanding illnesses. Depressed individuals experienced lower positive affect throughout the day, while differences in distressed affect were more pronounced in the morning. Loneliness was associated with lower positive affect and greater distressed affect independently of age, sex, marital status, paid employment, socioeconomic status, health, and depression. This study demonstrates that ecological momentary assessment of affect is feasible on a large scale in older individuals, and generates information about positive affect and distress that is complementary to standard questionnaire measures. The associations with loneliness highlight the everyday distress and reduced happiness and excitement experienced by lonely older men and women, and these may contribute to enhanced risks to physical and mental health.     

Death, suicide and the older adult.

Elderly people who are at high risk for suicide often have characteristics that are associated with reduced opportunity or inclination to communicate (e.g., male, living alone, residing in a low-income transient urban area, suffering from a depressive state). This paper attempts to provide converging perspectives on death and suicide from the standpoints of both the external observer and the elderly person. An interpretation of the statistical pattern is followed by a critique of current policy proposals for limiting society's response to the needs of vulnerable people on the basis of a "natural life span." Studies of elderly people themselves reveal a great diversity of attitudes toward death that is not well served by generalizations and stereotypes. However, it appears that stressful conditions of life arouse more anxiety among older people than does the prospect of death.     

Correlates of suicide in the older adult population in Quebec

This study was undertaken to describe the characteristics of adults aged 60 years and over who committed suicide in Quebec in 1998-1999. In this study, 42.6% of the suicide cases presented mental disorders at the time of their death, mainly depression. Sixty-five (65.3%) percent of the suicide cases would have been considered as having a mental health disorder if sub-threshold depression cases were included. Only 27.7% of the cases did not express any idea of death during the 6-month period preceding their suicide. One interesting finding was that 53.5% of the suicide cases consulted a general practitioner or specialist during the 2-week period preceding their death. Our results showed that only 8.1% had a severe level of functional limitations at the time of their death. This result leads us to interpret with caution the conclusion of some studies suggesting that physical frailty is a major causal factor associated with suicide among the elderly.     

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.     

Positive mental health moderates the association between depression and suicide ideation: A longitudinal study

Background/Objective: Depression and suicide ideation regularly occur together. Yet, little is known about factors that buffer individuals against the development of suicide ideation. The present study investigated, whether positive mental health buffers the association between depression and suicide ideation in a longitudinal study design. Methods: A total of 207 German students (70.3% female; age: M = 26.04, SD = 5.33) were assessed at a baseline evaluation and again twelve months later. Data were collected using self-report questionnaires. Linear hierarchical regression analysis was used to analyze the data. Positive mental health was considered to moderate the impact of depression on suicide ideation – controlling for age and gender. Results: Positive mental health was shown to moderate the impact of depression on suicide ideation: in those students who reported higher levels of positive mental health, depression severity showed no association with suicide ideation over time. Conclusion: Positive mental health seems to confer resilience and should be taken into account, when assessing individuals for suicide risk.     

Current suicide ideation and prior suicide attempts of bipolar patients as influences on caregiver burden

We examined whether caregivers of bipolar patients reporting current suicidal ideation and/or a history of a suicide attempt reported higher levels of burden and/or poorer health compared to caregivers of patients without these suicidality indices. In a cross-sectional design, caregivers (N = 480) associated with (a) patients with current suicidal ideation or (b) patients with a positive lifetime history of at least one suicide attempt, reported lower general health scores than caregivers associated with patients with neither of these indices. Parents of patients with at least one lifetime attempt reported more burden secondary to role dysfunction than spouses. Levels of depression in caregivers varied with whether the caregiver was a spouse or a parent, and whether patients had a history of suicide attempts, current suicidal ideation, or both.     

Suicidality in primary health care and national suicide rates

The incidence of suicidal symptoms for primary health care patients did not predict national suicide rates in a sample of 10 nations.     

Cognitive predictors of depression and suicide ideation

A total of 136 adult subjects who met the Research Diagnostic Criteria for major (unipolar) depression were assessed for intensity of depressive symptomatology (using the Hamilton Rating Scale for Depression and the Beck Depression Inventory) and for lethality of current suicide ideation (using the Scale for Suicide Ideation). In addition, they were administered a variety of questionnaires assessing cognitive variables presumed to mediate depression and suicidality. Multiple regression analyses indicated that depressive symptomatology was best predicted by Beck's Hopelessness Scale in combination with the Detachment factor of the Crandell Cognitions Inventory. In addition, suicidality was significantly predicted by the Selective Abstraction and Overgeneralization factors of Lefebvre's Cognitive Error Questionnaire, when the effects of the Beck Depression Inventory were partialed out. The practical implications of these findings for discriminating suicidal from nonsuicidal depressives are discussed.     

Suicide ideation: its relation to depression, suicide and suicide attempt

A random sample of 3,935 adults from a general population were interviewed and asked to report how often they had thoughts of suicide as well as their opinion on the frequency of suicide ideation in others. Depression was found to be related to the respondent's reports of his/her own suicidal thoughts and to reports of frequent suicide ideation in others. A total of 5.4 percent of the respondents reported some degree of suicide ideation in the previous month and 9.1 percent reported that others think about suicide once a month or more. When the demographic characteristics of those who report suicide ideation in themselves or others were compared to those of suicide attempters and committers, some consistencies were found, suggesting that such questions may be useful in identifying those "at risk." Nevertheless, sufficient discrepancies were found which suggest that there may be a number of factors which increase or decrease the likelihood that someone with thoughts of suicide will attempt or commit suicide. Follow-up studies are necessary to uncover such factors and the degrees to which they influence the occurrence of suicide.     

Sex differences in peer responsiveness to suicide ideation

Two surveys assessing attitudes toward and beliefs about suicide were conducted with undergraduates. There were 473 participants in Survey I and 692 participants in Survey II. Sex differences were found in participants' receptivity to suicidal individuals, beliefs about the behavior of suicidal peers, attitudes concerning the worth of suicidal people, incidence of adolescent suicide, and morality of suicide. There was no sex difference in participants' own frequency or seriousness of suicide ideation or suicide attempts. Results are discussed in terms of hypotheses concerning traditional socialization of males and females, resulting in sex-role differentiation that may influence attitudes toward and beliefs about suicide.     

Personality is associated with perceived health and functional status in older primary care patients

Using data collected on 265 primary care medical patients 60 years of age and older, the authors examined the personality bases of subjective health (perceived health, functional status) after controlling for observer-rated depression and medical burden. Four hypotheses were tested: High Neuroticism is associated with poorer perceived health, low Extraversion is associated with poorer perceived health, low Openness to Experience is associated with worse functional status, and age moderates the relationships between personality and subjective health. Findings supported the notion that personality is associated with subjective health; moreover, this effect appeared to grow more pronounced with increasing age. This study underscores the conceptual and heuristic value of examining moderators of the links between personality variables and health.     

Cognitive and psychomotor tests as predictors of on-road driving ability in older primary care patients

This study examined the accuracy with which different cognitive and psychomotor assessment tools were able to predict driving ability among older primary care patients. A cross-sectional study of 50 older drivers (with an average age of 73.1 ± 7.0 years) was conducted. Participants who had been referred by their physicians for psychological assessment following a fitness-to-drive examination underwent both an on-road driving test and a cognitive assessment protocol that included the Senior Drivers Battery (SDB) that is currently administered at the Mobility and Land Transports Institute (MLTI) in Portugal, the Useful Field of View (UFOV) test, the Stroke Drivers Screening Assessment (SDSA), Addenbrooke’s Cognitive Examination Revised (ACE-R), the Trail Making Test, the Key Search test, and the Wechsler Adult Intelligence Scale (WAIS-III) Vocabulary and Block Design tests. Logistic regression analysis revealed that the performances of the participants on the SDSA, ACE-R, UFOV and SDB were the best predictors of on-road driving. Specific measures of processing speed and divided attention, visuospatial abilities, executive functions, psychomotor speed and global cognitive functioning may be useful for predicting unsafe driving. The practical implications of these findings are discussed with a view to developing new assessment models for determining driving fitness in older adults.