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.     

The relationships among gratitude,self‐esteem,depression, and suicidal ideation among undergraduate students

The main purpose of this study was to examine the relationships among gratitude, self‐esteem, depression, and suicidal ideation. In total, 814 undergraduate participants (259 males and 555 females with mean age of 20.13 years) completed four inventories measuring the variables of interest. Analyses of structural equation modeling found that gratitude had direct effects on individuals' self‐esteem, depression, and suicidal ideation. In addition, gratitude had indirect effects on individuals' suicidal ideation via self‐esteem and depression, and self‐esteem had direct effects on individuals' depression. These results support the proposed model of suicidal ideation and contribute to the understanding of how gratitude influences individuals' suicidal ideation via psychological and physical variables.     

The Coping Self-Efficacy Scale: Psychometric properties in an outpatient sample of active duty military personnel

ABSTRACT

Active duty military service members endure a unique constellation of stressors while deployed or at home. Yet, assessment of protective factors against these stressors among active duty service members represents an under studied area. The present study advances the assessment of protective factors through the psychometric evaluation of the Coping Self-Efficacy Scale (CSES) in a clinical sample of military service members in mental health or substance abuse treatment (n = 200). Cross-sectional data were drawn from military medical records and a supplemental self-report questionnaire. Data extracted included demographic (e.g., sex, age), military characteristics (e.g., rank, years in service), physical health and mental health (e.g., anxiety, depression), and coping self-efficacy. Findings suggest a 3-factor (i.e., problem-focused coping, thought-stopping, and getting social support) CSES structure with acceptable internal consistency. Further, there were small-to-moderate associations with physical and mental health outcomes, providing evidence of construct validity. There were few significant associations with military-related characteristics. Finally, controlling for covariates, thought-stopping beliefs explained unique variance in suicide-related behaviors. Together, findings support the use of the CSES to measure coping-related beliefs in military service members. Recommendations are offered for future research and practice with active duty service members.     

Low self-esteem and hopelessness in childhood and suicidal ideation in early adulthood

This study examined the longitudinal relationship between family characteristics in early childhood, self-esteem, hopelessness and thoughts of self-harm in the midchildhood years, and suicidal ideation at ages 18 and 21. Path analysis was used to establish separate models for boys and girls. The results suggested different pathways to later suicidal ideation for boys and girls. For boys, suicidal ideation seemed to have stronger roots in childhood, with significant paths from low self-esteem and hopelessness to early thoughts of self-harm and thence to later ideation. For girls, self-esteem had a small but significant direct effect on later suicidal ideation. The findings provide support for the idea that individual characteristics such as feelings of hopelessness and low self-esteem act as generative mechanisms, linking early childhood family characteristics to suicidal ideation in early adulthood.     

Linking family dysfunction to suicidal ideation: Mediating roles of self-views and world-views

Research on suicide has documented various factors predicting suicidal ideation. The present study focused on the pathways emanating from one of the external, environmental forces (i.e. family dysfunction) through internal responses (beliefs about oneself and about the world), to suicidal ideation among Hong Kong Chinese. Using structural equation modelling, we tested the mediating roles of depressive self-views (including stress perception, depressive cognition and negative self-esteem) as well as two dimensions of social axioms (social cynicism and negative reward for application). Multi-group analysis showed that the mediation model was invariant across both males and females. Being socialized into a problematic family of origin affected multiple aspects of one's assessments of both oneself and one's world which, in turn, lead to greater suicidal ideation. Our findings provide important implications for assessing suicidal risk and guiding interventions in clinical treatment.     

Gender differences in adolescent coping behaviors and suicidal ideation: findings from a sample of 73,238 adolescents

Suicide among adolescents is an emerging global public health problem as well as a socioeconomic problem. Stress-coping strategies have been shown to be associated with suicidal ideation. We examined coping behaviors related to suicidal ideation and gender differences in adolescents using the data from the 2010 Korea Youth Risk Behavior Survey (ages 12–19 years; N = 73,238). Logistic regression analysis was used to evaluate associations between suicidal ideation and specific coping behaviors while controlling for potentially confounding variables. In both male and female groups, the coping behavior “drinking alcoholic beverages” and “smoking cigarettes” were positively associated with suicidal ideation. “Watching TV,” “playing online/mobile games,” and “sleeping” were negatively associated with suicidal ideation in both groups. In males, “engaging in sports” was negatively related to suicidal ideation. In females, “venting by talking to others” and “eating” were negatively related to suicidal ideation. The results indicate that there are gender differences in the effects of coping behaviors on adolescent suicidal ideation, and that developing adaptive coping strategies may function to reduce suicidality. Future studies are needed to examine whether improving coping skills can reduce suicidal ideation in a gender-specific manner.     

Meaning in life and its relationships with intrinsic religiosity,deliberate rumination,and emotional regulation

Meaning in life is one of the core elements of well‐being. Although meaning in life has received considerable research interest over the years, much of this research did not differentiate between the two categories of meaning, that is, search for meaning and meaning in life. The present study first investigated collective explanatory powers that intrinsic religiosity, deliberate rumination, and emotional regulation – three predictors selected based on past literature – have on these two types of meaning. In addition, mediational effects of deliberate rumination and emotional regulation in the links between intrinsic religiosity and search for meaning and presence of meaning were investigated. The participants were 326 undergraduate students in Seoul, South Korea. The hierarchical regression analyses found that while intrinsic religiosity contributed significantly in explaining only presence of meaning, deliberate rumination and emotional regulation had significant contributions in explaining both search for meaning and presence of meaning. Also, double mediational analysis using structural equation modelling revealed that deliberate rumination, but not emotional regulation, mediated the relationship between intrinsic religiosity and meaning in life. The implications and directions for future studies are also discussed.     

The relationship between pulmonary function and suicidal ideation in Korean adults: a nationwide survey

Controversy surrounds the association between lung function and mental health in the general population, and previous reported results were confounded by the effect of other chronic illnesses. This study aimed to investigate whether reduced lung function was related to mental health issues, taking into consideration the relevant potential confounders. We used data from the 2008–2013 Korean National Health and Nutrition Examination Survey to examine the relationship between lung function and three mental issues (recognized stress, depressive mood, and suicidal ideation) among 22,068 Korean adults. A multiple logistic regression with adjustment for potential covariates including chronic illnesses revealed that a .5-L decrement of forced vital capacity increased the risk for suicidal ideation in both genders, but there was no significant association with recognized stress or depressive mood. We found an inverse relationship between lung function and suicidal ideation in the Korean general population.     

Social support as a mediator of religious involvement and physical and emotional functioning in a national sample of African-Americans

Researchers propose social support as one of the factors that may explain the positive relationship often observed between religious involvement and health outcomes. African-Americans are a population that tends to have higher than average levels of religious involvement and are also disproportionately impacted by most health conditions. The present study sought to determine whether social support mediates the role of religious involvement in physical and emotional functioning and depressive symptoms, among a national probability sample of African-Americans (N = 803). Study participants completed telephone interviews. We used structural equation modelling to test hypotheses based on the theoretical model. Findings suggest evidence for a mediating role of belonging and tangible support in the association between religious behaviours and physical functioning as well as depression. There was no mediational role played by appraisal support, or for emotional functioning. Implications for faith-based health promotion interventions are discussed.     

Expressions of emotional distress in active duty military personnel with mild traumatic brain injury: A qualitative content analysis

Service members (SMs) who sustain traumatic brain injury (TBI) during deployment have increased risk for mental health issues. Mental health treatment can be challenging in military settings where treatment seeking is often stigmatized. Adequate care relies on accurate interpretations of SMs’ verbal accounts of distress, but little is known about how SMs, embedded in a culture that values resilience and self-reliance, relay emotional distress. We performed qualitative analyses of recordings from a telephone-based intervention with 25 SMs who sustained deployment-related mild TBI (mTBI) to elucidate thematic and dialectal patterns. Consistent with our expectations, SMs rarely used explicit depressive terms while discussing their emotional distress. More prevalent was language suggestive of an overarching theme of loss of control, whereby SMs’ stress, anxiety, and anger were often attributable to SMs’ perceptions that they had incomplete jurisdiction over their own lives. This study may help mental health providers improve engagements with SMs and Veterans, preventing misunderstandings and even improper diagnoses or referrals that could result from a strict reliance on the more customary expressions of distress.     

The Interplay Among Risk Factors for Suicidal Ideation and Suicide: The Role of Depression, Poor Health, and Loved Ones' Messages of Support and Criticism

When individuals who receive social support are in poor physical or mental health and are criticized or made to feel unwanted, they may perceive themselves as a burden. Poor physical health and depression were hypothesized to exacerbate the harmful effects on suicidal ideation of receiving critical negative messages and of receiving social support. These hypotheses were tested using secondary analyses of data from a sample of 533 unemployed married individuals who were assessed shortly after job loss, and 6 months later. The results of our analyses supported the hypotheses and demonstrated that for participants with poor health or high level of depressive symptoms an increase in critical messages and social support (from Time 1 to Time 2) predicted increased suicidal ideation. This relationship was not observed for non- depressed participants in good health. The results are discussed in terms of their implications for suicide prevention.     

Prevalence of suicidal ideation and associated factors among postpartum HIV-positive women in health facilities,South Africa

The goal of this study was to investigate the prevalence of suicidal ideation and its associated factors in postpartum HIV-positive women in South Africa . A cross-sectional survey was carried out on 580 HIV positive postnatal women (M = 28 .5 years; SD = 5 .8) in 48 health facilities in Nkangala district, Mpumalanga, South Africa . Results indicate that 41 .2% of women reported suicidal ideation in the postnatal period . In multivariate analysis, receiving money from the family, having been diagnosed with a sexually transmitted infection (STI) (other than HIV) in the past year, and lack of social support were found to be associated with suicidal ideation . In conclusion, suicidal ideation is common among HIV positive postpartum women, which calls for inclusion of suicidality risk assessment and management protocols in interventions targeting postpartum women living with HIV .     

Meaning in life and adjustment to daily stressors

People perceive their life as meaningful when they find coherence in the environment. Given that meaning of life is tied to making sense of life events, people who lack meaning would be more threatened by stressful life events than those with a strong sense of meaning in life. Four studies demonstrated links between perceptions of life’s meaningfulness and perceived levels of stress. In Study 1, participants with lower levels of meaning in life reported greater stress than those who reported higher meaning in life. In Study 2 and Study 3, participants whose meaning in life had been threatened experienced greater stress than those whose meaning in life had been left intact. In Study 4, anticipation of future stress caused participants to rate themselves higher on the quest for meaning in life. These findings suggest that perceiving life as meaningful functions as a buffer against stressors.     

Brooding and reflection: rumination predicts suicidal ideation at 1-year follow-up in a community sample

The cognitive processes underlying suicidal thinking and behavior are not well understood. The present study examined brooding and reflection, two dimensions of rumination, as predictors of suicidal ideation among a community sample of 1134 adults. Participants completed self-report measures of rumination and depression, and a semi-structured clinical interview that included an assessment of suicidal ideation, at baseline and 1-year follow-up. Brooding was more strongly related to degree of ideation at baseline than was reflection. However, both brooding and reflection predicted whether an individual thought about suicide at 1-year follow-up, even after adjusting for baseline suicidal ideation. Symptoms of depression mediated the relationship between brooding and ideation but not that between reflection and ideation. Implications for the nature of thought processes that result in suicidal thinking are discussed.     

Meaning in life across the life span: Levels and correlates of meaning in life from emerging adulthood to older adulthood

Meaning in life is thought to be important to well-being throughout the human life span. We assessed the structure, levels, and correlates of the presence of meaning in life, and the search for meaning, within four life stage groups: emerging adulthood, young adulthood, middle-age adulthood, and older adulthood. Results from a sample of Internet users (N = 8756) demonstrated the structural invariance of the meaning measure used across life stages. Those at later life stages generally reported a greater presence of meaning in their lives, whereas those at earlier life stages reported higher levels of searching for meaning. Correlations revealed that the presence of meaning has similar relations to well-being across life stages, whereas searching for meaning is more strongly associated with well-being deficits at later life stages.