Perceived Burdensomeness Predicts Outcomes of Short‐Term Psychological Treatment of Young People at Risk of Suicide

The interpersonal‐psychological theory of suicide (IPTS; Joiner, 2005 ) provides a model for understanding the mechanisms underlying suicide risk, but there is limited research measuring change in the constructs over the course of treatment. This study aimed to test whether changes in perceived burdensomeness (PB) and thwarted belongingness (TB) mediated the effects of changes in depression and hopelessness on suicide risk. The sample comprised 226 Australian young people (aged 12–24; 67.7% female; 5.7% Aboriginal and Torres Strait Islander) receiving short‐term psychological treatment for suicide‐related behaviors. Change scores over the course of therapy were generated using admission and discharge measures of PB, TB, depression, hopelessness, and suicide risk. Results revealed partial support for the theory. The relationship between changes in depression and hopelessness on suicide risk was fully mediated by changes in PB. However, changes in TB did not mediate these relationships. This study offers encouragement for the potential use of the IPTS in the context of psychological treatment of young people. Assessment of the IPTS constructs may be helpful in assessing change in suicide risk and further assist in treatment.     

An Examination of the Connections Between Eating Disorder Symptoms,Perceived Burdensomeness,Thwarted Belongingness,and Suicide Risk Among Undergraduate Students

Suicide attempts and premature mortality due to suicide are elevated in people with eating disorders. Informed by the interpersonal theory of suicide, two studies examined the role of perceived burdensomeness and thwarted belongingness in explaining the association between eating disorder symptoms and suicide risk. Results indicated that various eating disorder symptoms had an indirect effect on suicide risk through perceived burdensomeness and thwarted belongingness. Targeting perceived burdensomeness and thwarted belongingness may be useful for decreasing suicide risk among undergraduates with eating disorder symptoms.     

A Five‐Month Longitudinal Study of Psychache and Suicide Ideation: Replication in General and High‐Risk University Students

Shneidman's (1993) model of psychache as the cause of suicide was evaluated in a 5‐month longitudinal study of psychological pain and suicide ideation. Replicating across general (N = 683) and high‐risk undergraduates (N = 262), psychache was significantly associated with suicide ideation, and change in psychache was significantly associated with change in suicide ideation. For general suicide ideation and suicide preparation, these significant results were maintained even when depression and hopelessness were statistically controlled. This research is a unique contribution being the first large‐sample longitudinal study that evaluates and supports Shneidman's psychache causal model of suicidality in general and high‐risk groups.     

Treatment‐Resistant Depression and Risk of Suicide

We evaluated whether treatment‐resistant depression (TRD) as measured by the Massachusetts General Hospital (MGH) staging method was associated with suicide in a large U.S. health system. Data from the Veterans Health Administration and the National Death Index were used to conduct a case–control study of patients newly diagnosed with depression who received antidepressant treatment between 2003 and 2006. Suicide cases (N = 499) were matched with nonsuicide controls (N = 1994). Conditional logistic regression was used to assess whether MGH stage at time of suicide (or matched date) was associated with case status, adjusting for patient demographic characteristics, comorbidity, and service use. Results indicated 11.6% of suicide cases had MGH stage 3 or greater (indicating at least two antidepressant trials) compared to 6.4% of controls (p < .001). In adjusted analyses, suicide was not significantly more likely among patients with stage 3 or greater (OR 1.52; 95% CI: 0.98, 2.37) or stages 1.5–2.5 (OR 1.19; 95% CI: 0.91, 1.55) compared to patients with stage 1 or less (<10 weeks of antidepressant medication). Staging TRD using MGH criteria is unlikely to substantially improve suicide risk assessment of depressed patients beyond existing measures contained in health system records.     

The Development and Validation of Brief and Ultrabrief Measures of Values

Values are a central personality construct and the importance of studying them has been well established. To encourage researchers to integrate measures of values into their studies, brief and ultrabrief instruments were developed to recapture the 10 values measured by the 40-item Portrait Values Questionnaire (PVQ; Schwartz, 2003 Schwartz, S. H. (2003). A proposal for measuring value orientations across nations. In Questionnaire development report of the European Social Survey (pp. 259–319). Retrieved from http://www.europeansocialsurvey.org/index.php?option=com_docman&;task=doc_view&;gid=126&;Itemid=80 [Google Scholar]). Rigorous psychometric procedures based on separate derivation (N = 38,049) and evaluation (N = 29,143) samples yielded 10- and 20-item measures of values, which proved to be successful at capturing the patterns and magnitude of correlations associated with the original PVQ. These instruments should be useful to researchers who would like to incorporate a values scale into their study but do not have the space to administer a longer measure.     

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.     

The Perceived Ethnic Discrimination Questionnaire: Development and Preliminary Validation of a Community Version1

This paper describes 2 studies that evaluated a new instrument, the Perceived Ethnic Discrimination Questionnaire‐Community Version (PEDQ‐CV). The PEDQ‐CV can be used across ethnic groups to assess perceived racism or ethnic discrimination. The scales measure several subdimensions of racism, permitting the examination of different forms of this race‐related stressor. The first study evaluated the psychometric properties of the PEDQ‐CV in a large sample of community‐dwelling adults. The second evaluated psychometric properties of a brief version of the PEDQ‐CV, developed for research protocols requiring a shorter administration time. Tests were made of reliability and several forms of construct validity. Both versions of the PEDQ‐CV have good reliability and construct validity. The PEDQ‐CV can facilitate the development of an integrative body of knowledge across different ethnic groups regarding the existence, determinants, and consequences of discrimination.     

Suicide on Railroad Rights‐of‐Way: A Psychological Autopsy Study

Findings from 55 psychological autopsies of decedents who perished on U.S. railroad rights‐of‐way between October 1, 2007, and September 30, 2010 are reported. Described are distal, proximal, and contextual factors of risk; understandings of why these suicides occurred on railroad rights‐of‐way; and opportunities for prevention of similar suicides. International comparisons of suicides on railroad rights‐of‐way are made to highlight distinct findings regarding U.S. cases. Decedents studied exhibited considerable predisposing risk for suicide, with a high prevalence of severe mental disorders and substance abuse. In addition, a number of acute risk factors were commonly observed, notably suicide ideation, hopelessness, anxiety, and anger. In the context of that acute risk, associated situational variables and a relative absence of protective factors are described.     

On the linearity of predefined and self‐anchoring Visual Analogue Scales

Two functional measurement studies were conducted to test the effect of two types of end anchors on the linearity of Visual Analogue Scale (VAS) data. With the first type of end anchors, participants responded to the stimuli using a VAS with predefined end anchors. With the second type, respondents defined the end anchors in terms of their own assumptions, perceptions, goals and values. The results show that VASs can be considered as linear scales and that the type of end anchors used has no effect on the linearity of the VAS data.     

Suicide Attempts and Suicide among Marines: A Decade of Follow‐up

Suicidal behavior among military personnel is of paramount public health importance because of the increased risk of death from suicide in this population. Pre‐ and post‐Marine recruit training risk factors for suicide attempts among current and former Marines were examined in 10 years following recruit training. The characteristics of the subsample of current and former Marines who died by suicide during this time are also described. Stressful and traumatic life events (e.g., childhood physical, sexual, and emotional abuse, sexual harassment during recruit training) and pre‐recruit training suicide attempts emerged as having strong associations with post‐recruit training attempts. Half of those who died by suicide in the 10 years following recruit training endorsed at least one significant life stressor prior to joining the Marines. This study highlights the importance of screening for stressful and potentially traumatic experiences occurring both before and during military service as part of a comprehensive suicide risk assessment in military samples.     

A Study of the Use and Interpretation of Standardized Suicide Risk Assessment: Measures within a Psychiatrically Hospitalized Correctional Population

The reliability, validity, and utility of the Adult Suicidal Ideation Questionnaire (ASIQ), Beck Hopelessness Scale (BHS), Beck Scale for Suicide Ideation (BSS), and Reasons for Attempting Suicide Questionnaire (RASQ) with correctional mental health populations was evaluated. Evidence was found indicating good to excellent reliability for all measures. Each of the measures significantly differentiated multiple attempters from single attempters and nonattempters, providing evidence of convergent and divergent validity. Logistic regression and receiver operating characteristic analyses revealed strong associations between multiple attempts and the ASIQ, BSS, and RASQ, but not the BHS. Implications for suicide risk assessment processes in correctional settings are discussed.     

Victimization and Exposure to Pro‐Self‐Harm and Pro‐Suicide Websites: A Cross‐National Study

The study of websites displaying methods of both physical self‐harm and suicide has become an important aspect of deliberate self‐injury and suicide research. However, little is known about contextual factors related to entering such sites. Using data from 3,567 respondents aged 15–30 in the US, UK, Germany, and Finland, we found that experiences of victimization are associated with entering pro‐self‐harm sites and pro‐suicide sites. Also, the victimization context had relevance, as online victimization was particularly related to pro‐self‐harm behavior. The findings suggest a need to organize more specific online support for the victims of violence and online aggression.     

Describing and Measuring the Pathway to Suicide Attempts: A Preliminary Study

To die by suicide, one must think about suicide, make a plan, and then carry it out. Prior research has examined the presence and predictors of these outcomes; however, virtually no studies have characterized how these steps unfold along the pathway to suicide. A novel instrument was administered to 30 recent suicide attempters. Results revealed that although the median onset for suicidal ideation occurs 1 to 5 years prior to attempting, the median for 6 of the 10 steps measured was within 6 hours of attempting. Overall, 86.5% of proximal planning steps took place within 1 week of attempting and 66.6% occurred within 12 hours.     

The Relationship Between General Population Suicide Rates and Educational Attainment: A Cross‐National Study

Suicides are associated with both high and low levels of intelligence and educational attainment in both individual‐level and aggregate‐level studies. A cross‐national study examining the relationship between general population suicide rates (y) and educational attainment (x) was undertaken with the a priori hypothesis that the relationship would be curvilinear and follow a U‐shaped curve with the quadratic equation Y = A + BX + CX², where A, B, and C are constants. Data on suicide rates and the Education Index (a proxy measure of educational attainment) were ascertained from the World Health Organization and the United Nations Web sites, respectively. The main finding was the predicted curvilinear relationship between general population suicide rates, in both sexes, and the Education Index fit the above quadratic equation. Given the cross‐sectional study design, a causal relationship cannot be assumed. The impact of educational attainment on general population suicide rates may occur through interaction with other factors, mediation of the effects of other factors, or by its effects being mediated by other factors, and require further study.