Sources of Psychological Pain and Suicidal Thoughts Among Homeless Adults

Homeless adults experience problems in multiple areas of their lives. It was hypothesized that adults who were troubled by problems in more areas of their lives would be more likely to report suicidal thoughts. The sample included 457 homeless men and women who resided in three emergency shelters. The number of sources of psychological pain, past suicide attempts, and being a man predicted current suicidal thoughts, but being diagnosed with a depressive disorder did not. Shelter workers should ask adults whether they have attempted suicide in the past and how troubled they are by each area of their lives.     

The association between homelessness and suicidal ideation and behaviors: results of a cross-sectional survey

This study was carried out with three goals: (1) to determine the prevalence of suicidal ideation and suicide attempts among the homeless; (2) to determine what aspects of homelessness predict suicidality, and (3) to determine which aspects remain predictive after controlling for key covariates, such as mental illness. A sample of 330 homeless adults were interviewed. Sixty-one percent of the study sample reported suicidal ideation and 34% had attempted suicide. Fifty-six percent of the men and 78% of the women reported prior suicidal ideation, while 28 percent of the men and 57% of the women had attempted suicide. Childhood homelessness of at least 1 week without family members and periods of homelessness longer than 6 months were found to be associated with suicidal ideation. Psychiatric diagnoses were also associated with suicidality in this sample.     

Reports of attempted suicide among Brazilian addicts

Both substance dependence and depressive mood seem to be associated with increased suicide risk. Clinical information on suicide attempts and depressive symptoms were obtained from a sample of 211 psychoactive substance dependents attending a university clinic program for addicts in Brazil. 49 subjects (23.4%) had attempted suicide at least once, and the frequency of reporting attempts was 4.32 times greater among women than among men. Male addicts also tended to engage in potentially more dangerous attempt methods than women. Depressive male addicts were 2.17 times more likely to have attempted suicide than nondepressive addicted men. Among women, no association could be established between having attempted suicide and the presence of depression. Substance addicts have a relatively high risk of attempting suicide and the co-occurrence of depression seems to increase prevalence of suicidal behavior among men.     

Suicidal behavior among youth with severe emotional disturbance

The purpose of this study was to replicate an investigation of risk behaviors associated with suicidal behavior in public high school students, in a population of high school age youth with severe emotional disturbance (SED). Subjects for the study were clients of the South Carolina Continuum of Care (COC) (N=83). Information on suicidal thoughts and acts, aggressive behaviors, substance use and physical recklessness was gathered using a modified version of the self-report National Youth Risk Behavior Survey. Four percent of the youth reported seriously considering suicide, 8% reported planning how they would attempt suicide, 10% reported actually attempting suicide at least once, and 6% reported attempts requiring medical treatment Of the 13 youth who reported attempting suicide, four (31%) did not report planning an attempt. All suicidal behaviors except thoughts occurred more in girls than boys with SED. Alcohol and illicit drug use were associated with suicidal behavior, with larger odds ratios for attempts than for thoughts/plans. Youth with SED who use alcohol and illicit substances are particularly at risk of suicidal behavior. A high index of suspicion is appropriate when evaluating suicidal risk in girls with SED, especially in the presence of known alcohol or substance use.Continuum of Care for Emotionally Disturbed Children Division, S. C. Office of the Governor.     

Suicidal behavior, negative affect, gender, and self-reported delinquency in college students

The associations among suicidal behavior, negative affect, and delinquency were assessed via an anonymous self-report survey administered to male and female college students ( N = 383). Contrary to our hypothesized results, there were no gender differences in rates of suicidal ideation and attempts. Confirming our hypotheses about gender differences, college men did report significantly more delinquent behavior than college women. College men also scored higher on the suicide-proneness scale, which contained a mixture of death-related, risk-related, and negative self- and health-related items. Furthermore, as predicted, college students with a history of depression, suicide ideation, and/or suicide attempts all reported significantly more delinquent behavior. Self-reported delinquency and current levels of depressive symptomology emerged as significant predictors of suicide-prone behavior for both college men and women, explaining 34% of the variance for women and 17% for men. Levels of engagement in suicide-prone behavior and feelings of depression were elevated in college students with any type of juvenile arrest history. Students with an arrest history were also more likely to have had a diagnosis of depression and to have engaged in suicide ideation in their past. These findings suggest there are complex links between depression, delinquency, and suicidal behavior in college men and women.     

History of military service and the risk of suicidal ideation: findings from the 2008 national survey on drug use and health

Studies of completed suicide by history of military service have produced inconsistent findings; no representative population‐based study has compared the risk of nonfatal suicidal behavior among veterans with risk among nonveterans. The objective of this study was to examine whether male veterans of the U.S. military are at heightened risk of suicidal ideation, compared with males who never served in the U.S. military. A total of 17,641 adult men completed the 2008 National Survey on Drug Use and Health (NSDUH). Subjects provided information about history of ever having served in the U.S. armed forces, past suicidal ideation, alcohol and drug abuse and dependence, measures of psychological distress, and sociodemographic data. Overall, men who had ever served in the armed forces were no more likely than men who had never served to report having seriously considered suicide over the prior 12 months. Military status was not differentially associated with other known suicide risk factors assessed by NSDUH, including psychiatric disorders. Our findings suggest that evidence‐based suicide prevention strategies applicable to the general population should be employed to reduce suicide risk among the veteran population as well.     

The Suicidal Ideation Attributes Scale (SIDAS): Community‐Based Validation Study of a New Scale for the Measurement of Suicidal Ideation

While suicide prevention efforts are increasingly being delivered using technology, no scales have been developed specifically for web‐based use. The Suicidal Ideation Attributes Scale (SIDAS) was developed and validated as a brief, web‐based measure for severity of suicidal ideation, using an online survey of Australian adults (n = 1,352). The SIDAS demonstrated high internal consistency and good convergent validity. Frequency and controllability of thoughts were more strongly associated with suicide plans and attempts than other attributes assessed. Scores ≥ 21 indicated high risk of suicide behavior. The SIDAS appears to be a valid web‐based measure for severity of suicidal ideation.     

Is IQ in Childhood Associated with Suicidal Thoughts and Attempts? Findings from The Mater University Study of Pregnancy and Its Outcomes

This study explores associations of IQ at age 14 with adult symptoms of suicidal thoughts and attempts at age 21. Analysis was based on the Mater University Study of Pregnancy and its outcomes, an Australian prospective birth cohort study started in Brisbane Australia in 1981. We assessed associations with suicide thoughts, plans, and attempts. We used two measures of IQ: the Raven's Standard Progressive Matrices and the Wide Range Achievement Test. In multivariable analyses, there was an inverse association between Raven's IQ and suicide thoughts, plans, and attempts, but no strong evidence of an association between the WRAT3 and the three suicidal items. Specific aspects of intelligence may be associated with suicidal thoughts, plans, and attempts.     

The Comorbidity of Post-traumatic Stress Disorder and Suicidality in Vietnam Veterans

Vietnam veterans (N = 232) recruited from three sources were assessed for suicidal thinking and behaviors, and symptoms of posttraumatic stress disorder (PTSD) and depression. Findings support the notion that suicidal thoughts are prevalent in this group, with veterans in psychotherapy reporting a greater likelihood of such symptoms (82.6%) than veterans in the community (35.7%) or those seeking assistance through a veteran's outreach center (66.7%). Thoughts of ending one's life and a previous suicide attempt were significantly correlated with a diagnosis of PTSD (r = .53, p < .001; and r = .33, p < .001, respectively). Veterans with a diagnosis of PTSD and depression or dysthymia were also more likely to report suicidal thinking and behaviors than veterans with only one of the diagnoses.     

Examining the Interpersonal–Psychological Theory of Suicide in an Inpatient Veteran Sample

Suicide among veterans is a pressing public health concern. The interpersonal–psychological theory of suicide proposes that perceived burdensomeness and thwarted belongingness lead to suicidal desire, whereas the acquired capability for suicide leads to suicide attempt in the presence of suicidal desire (Joiner, 2005). Two hypotheses derived from the interpersonal–psychological theory of suicide were tested in 185 veterans (96 women) entering inpatient psychiatric treatment. Burdensomeness and its interaction with belongingness significantly predicted current suicidal ideation. The three‐way interaction between burdensomeness, belongingness, and acquired capability did not significantly predict number of past suicide attempts. Clinical implications and directions for future research are discussed.     

Child/Adolescent Abuse and Suicidal Behavior: Are They Sex Related?

The association between childhood and adolescent abuse and suicidal behavior, and the possible contribution of abuse to sex differences in non lethal suicidal behavior, was investigated. Data were extracted from the Israel‐based component of the WHO World Mental Health Survey (Kessler & Utsun, 2008a). Increased risk for ideation, plan, and suicidal attempt were associated with childhood abuse, and increased risk for attempt was associated also with abuse at adolescence. No associations with sex or sex by abuse interactions were observed. The higher frequency of childhood abuse among women could account in part for their higher rates of suicidal attempts as compared to men.     

Gender in Suicide Attempt Rates and Childhood Sexual Abuse Rates: Is There an Interaction?

Two competing explanations for higher rates of attempted suicide in women than men were compared. Because childhood sexual abuse is more prevalent in girls than boys, one explanation of higher rates of suicide attempts in women is that it is a direct result of the higher incidence of sexual abuse in girls. Alternatively, higher rates of suicide attempts might result from gender differences in the impact of childhood sexual abuse on suicidal behavior. To compare these theories, data from 1,889 abstinent, substance-dependent patients who completed the Childhood Trauma Questionnaire (CTQ) and who were interviewed about suicide attempts was examined. Scores on each scale of the CTQ were examined as a function of gender and attempter status. Results showed higher rates of suicide attempts in women than in men, higher CTQ scores in women than men, and a higher CTQ score in attempters than nonattempters. However, logistic regression indicated that gender and abuse did not interact to determine attempter status. Thus, the data support the first hypothesis that the greater frequency of suicide attempts in women may be partly attributed to the higher prevalence of childhood sexual abuse in girls. The generalizability of these results to the general population and to other diagnostic groups requires further study.     

Mediators of the relationship between childhood sexual abuse and suicidal behavior in borderline personality disorder

A history of childhood sexual abuse (CSA) increases the risk of suicidal behavior and the lifetime number of suicide attempts in adults with BPD. Despite a strong association, specific variables mediating the relationship between CSA and adult suicidal behavior in BPD have not been identified. This study examined risk factors for suicidal behavior as potential mediators of the relationship between CSA and suicide attempts in 151 men and women with BPD. Diagnostic, clinical, and psychosocial risk factors, as well as CSA, and suicidal behaviors, were assessed by standardized interviews or self-rated measures. Psychotic and schizotypal symptoms, and poor social adjustment, were associated with both CSA and suicidal behavior, and partially mediated the relationship between CSA and attempter status. Psychotic and schizotypal symptoms in BPD define a vulnerability to cognitive and perceptual distortions under stress. They increase the likelihood of suicidal behavior in BPD, especially in the absence of mitigating social support. A theoretical model for suicidal behavior in BPD is presented which integrates direct, mediated, and moderated pathways between childhood sexual abuse and temperament, adolescent and adult risk factors, and suicidal behavior.     

The prevalence of suicidal ideation among college students

A total of 737 university students were surveyed using a psychometrically sound self-report measure of suicidal ideation. Over 43% of those participating were found to have experienced some level of suicidal ideation during the previous year. Of those found to have had suicidal thoughts, 14.9% in some way acted on those thoughts without actually making suicide attempts. An additional 5.5% were found to have made attempts on their lives. Serious suicidal ideation and actual attempts were related to several demographic traits, and implications of the results are discussed. In general, findings indicate that the problem of youth suicide may involve a greater percentage of young people than previously thought. Moreover, findings provide indirect support for the hypothesis that the difference in male-female completed suicide rates is primarily a function of the lethality of the attempts.     

Predictors of Suicidal Ideation in a Gender‐Stratified Sample of OEF/OIF Veterans

There is a growing concern about suicide among Operation Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF) veterans. We examined the role of postdeployment mental health in associations between deployment stressors and postdeployment suicidal ideation (SI) in a national sample of 2,321 female and male OEF/OIF veterans. Data were obtained via survey, and path analysis was used. For women and men, mental health symptoms largely accounted for associations between deployment stressors and SI; however, they only partly accounted for the sexual harassment and SI association among women. These findings enhance the understanding of the mental health profile of OEF/OIF veterans.     

A cross-cultural investigation of the communication of suicidal intent in Swedish and Turkish adolescents

A recent study found that Swedish adolescents were more disapproving of a suicidal disclosure by a fictional friend than their Turkish counterparts. Given this finding, the present study investigated whether or not more adolescents in Turkey than in Sweden disclose their own suicidal thoughts to someone, to whom adolescents disclose their suicidal thoughts, what reactions such disclosures produce, and reasons for not disclosing suicidal feelings among 966 Swedish and 956 Turkish high school students. A questionnaire was used to collect information about different aspects of suicidal disclosures. More Turkish than Swedish adolescent suicide ideators disclosed their thoughts. More Turkish than Swedish students believed also that young people thinking about and planning suicide tell others of their plans and thereby ask for help. An overwhelming majority of adolescents in both groups revealed their thoughts to peers. The social reactions to suicidal disclosures in both samples were mainly positive. The two most common reasons for not disclosing in both groups involved interpersonal hopelessness. Adolescents who disclosed their past suicidal thoughts to someone reported having lower current suicidal ideation than those who had not. In line with favorable social attitudes towards suicidal disclosures and lower suicidal mortality rates in Turkey compared with Sweden, more Turkish than Swedish adolescents reported having disclosed their own suicidal thoughts to someone in their social milieu.     

Suicidal women and their relationships with husbands, boyfriends, and lovers

This study describes the specific conflicts which suicidal women experience in their intimate relationships with men. Fifty women who had made suicide attempts were studied with a focus on the contributing role of their relationships with men to the genesis of the suicidal acts. Four major themes were found in the relationships: "smothering love", infidelity, battering, and denial of affection. The women experienced these conflicts as major precipitants in their suicidal behaviors. Examples of the four themes are described and analyzed.     

Effect of Socioeconomic Status on the Linkage Between Suicidal Ideation and Suicide Attempts

Previous suicide attempts are a leading risk factor for completed suicide. To identify specific characteristics of those at high risk for attempts, we investigated associations with socioeconomic status (SES). Data from the 2013 Korean Community Health Survey (KCHS) included adults who reported suicidal ideation (N = 220,245). Attempts in the past 12 months were assessed. Associations of demographic, socioeconomic, and suicide‐related behavioral factors were analyzed using multiple logistic regression. Among those with suicidal ideation, 862 (3.9%) had attempted suicide. After stratification by age and gender, results showed that low education and unemployed young adult men and women had significantly higher rates of attempts. The lowest income level was associated with significantly higher rates of attempts in only young adult women. Among those with the lowest and highest income, the association between ideation and attempts was attenuated, whereas it was enhanced among other income groups.     

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.     

Residential Transience,Major Depressive Episodes,and the Risk of Suicidal Thoughts,Plans, and Attempts

The association between past‐year residential transience (frequent moving) and suicidal ideation among a nationally representative sample of over 190,000 U.S. adults was evaluated. Suicidal thoughts, plans, and attempts were more prevalent among transient adults. Among adults without major depressive episodes (MDE), transience was associated with 70% to 90% greater odds of suicidal ideation compared to nontransient adults. Among adults with MDE, transience was associated with a 60% to 80% increased odds of suicidal ideation compared to nontransient adults. Residential transience may be an indicator for increased suicide risk even in the absence of depression.