Prognosis after Adolescent Suicide Attempt: Mental Health,Psychiatric Treatment,and Suicide Attempts in a Nine‐Year Follow‐up Study

The prevalence of mental health and suicidal behavior was examined 8 to 10 years after an adolescent suicide attempt. Of 71 persons, 79% had at least one psychiatric disorder (mean 1.7) at follow‐up, most commonly depression (46%), personality disorder (46%), and anxiety disorder (42%). The stability of diagnoses was moderate. The suicide attempters had received a substantial amount of treatment. One third had received inpatient treatment, and 78% psychiatric treatment, despite low compliance shortly after the index suicide attempt. At follow‐up, repeated suicide attempts were found in 44% of the sample, and half of those had an affective or personality disorder.     

Childhood Abuse,Nonsuicidal Self‐Injury,and Suicide Attempts: An Exploration of Gender Differences in Incarcerated Adults

The relationship between types of childhood abuse, suicide attempts, and nonsuicidal self‐injury (NSSI) was examined in a sample of 415 incarcerated adults (268 men, 147 women). Men and women were equally likely to experience childhood abuse, although women were more likely to report sexual abuse and men were more likely to report emotional neglect. Sexual abuse was the only type of abuse found to predict NSSI and suicide attempts in women. For men, physical abuse and physical neglect were significant predictors of NSSI and suicide attempts, respectively. Gender differences exist and should be examined in future research in this area.     

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.     

Assessing Parental Readiness to Change: A Psychometric Evaluation of the READI-SF in a Community Sample

Engagement in behavioral parent training programs continues to be a barrier to service delivery. Parental readiness is an important construct for understanding parental engagement in parent training services, as these programs place a high level of action-oriented demands on caregivers. The present study examines the performance of one parental readiness measure, the Readiness, Efficacy, Attributions, Defensiveness, and Importance Scale—Short Form (READI-SF) in a community-based sample. Participants included 103 families of children ages three to seven recruited from an urban charter school. Mothers completed an abbreviated version of the READI as well as indices of child disruptive behavior and a second measure of parental readiness. The psychometric properties and factor structure of the READI-SF are explored as well as indices of reliability and validity. Exploratory factor analysis revealed a three-factor model of readiness to change, treatment readiness, and perceived importance of the problem. Analyses also supported the validity and clinical utility of the measure, as READI-SF scores were found to predict attendance at a one-time parenting group. Lastly, the study examines the relationship between parental readiness and child disruptive behavior. Limitations and future directions are discussed.     

Longitudinal Changes of Planned Happenstance Skills by Gender,Community Types,and Employment Status in a Sample of College Students in School‐to‐Work Transition

This study examined the characteristics of college students who are transitioning from school to work by measuring their mean differences on planned happenstance skills subscales at 3 separate time points. The results indicated that the mean of planned happenstance skills changed across the 3 time points and are somewhat different through demographic factors, such as gender, community types, and employment status. In addition, 2‐way and 3‐way multivariate analysis of variance results showed that the interaction effects of 3 demographic variables on 5 planned happenstance skills were not significant. Practical implications for career counselors are discussed.     

Trauma and Health Symptoms in a Community Sample: Examining the Influences of Gender and Daily Stress

Although there is a rich body of literature on trauma and health, limited research has investigated the variables of gender, trauma symptoms, physical health, mental health, and daily stress together in a community sample. Considering the deleterious effects of trauma on health, our overarching inquiry was whether trauma symptoms can predict overall mental and physical health with attention to gender and daily stress as potential moderators. Participants (n = 103; 50.5% women) completed self-report measures of trauma symptoms, mental health, physical health, and daily stress, along with demographic information. Trauma symptoms predicted 25.2% of the variance in general health symptoms. Gender significantly added to the variance accounted for, but daily stress was not significant in the model. Trauma symptoms predicted 37.1% of the variance in mental health symptoms. Daily stress significantly added to the model, but gender did not. Results are interpreted through the integration of family stress theory and feminist frameworks, adding to the literature by further illuminating the relationships between gender, daily stress, health symptoms, and trauma in a community sample.     

Imagery Use and Self‐Determined Motivations in a Community Sample of Exercisers and Non‐Exercisers1

This study examined the patterns of imagery use and motivational self‐determination, and the relationships between them in regular exercisers (RE), non‐exercisers who intend to exercise (NE‐I), and non‐exercisers who do not intend to exercise (NE‐N). A survey was conducted through the random sampling of a large population. The NE‐N group reported using the same amount of imagery as the other 2 groups. NE‐N participants were the least and RE participants the most self‐determined, with NE‐I participants in between. The patterns of association among imagery and self‐determination were different for the NE‐N participants than the other 2 groups. It was concluded that imagery interventions that might be successful with RE and NE‐I participants are unlikely to be effective with NE‐N participants.     

Suicide Crisis Syndrome Mediates the Relationship Between Long‐term Risk Factors and Lifetime Suicidal Phenomena

In recent years, there has been growing attention to the distinction between acute and long‐term suicidal risk factors. We have previously characterized an acute, negative affect state, termed the suicide crisis syndrome (SCS ), as a marker of near‐term suicidal risk. Here, we test whether documented long‐term risk factors (i.e., trait vulnerabilities), including perfectionism, impulsivity, chronic substance abuse, insecure attachment, poor social support, and childhood trauma, associate to suicidal phenomena through a pathway of the SCS . A sample of 207 psychiatric inpatients were administered a battery of eight scales, including the Suicide Trigger Scale (STS ‐3) as a measure of the SCS . While both STS ‐3 and all trait vulnerabilities were associated with lifetime suicidal ideation and attempts, only STS ‐3 was related to pre‐admission suicide attempts. The STS ‐3 significantly mediated the effect of each trait vulnerability on lifetime suicidal phenomena (combining ideation and behavior), with the proportion of mediating effect ranging from .29 to .56. Reverse mediation analyses were only significant for insecure attachment, supporting a largely unidirectional mediation effect. The SCS appears to serve as an acute risk factor for suicidal behavior in psychiatric inpatients and may act as a mechanism by which long‐term risk factors increase suicidal risk.     

Definitions of Suicide and Self‐Harm Behavior in an Australian Aboriginal Community

In this small qualitative grounded theory study (21 interviews and focus groups with a total of 26 participants) investigating the understandings of and attitudes toward suicide and self‐harm of Aboriginal peoples in a coastal region of New South Wales, Australia, we found that cultural factors particular to these communities influence the way such behavior is defined in an Aboriginal context. A continuation of certain “traditional” cultural forms of self‐harm behavior was evident in participant definitions, notably the practice of female hair cutting, also described as a mourning ritual, which appears to serve as a marker both to the individual and others.     

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.     

Real‐World Correlates of Performance on Heuristics and Biases Tasks in a Community Sample

In the current study, we sought to examine whether performance on several heuristics and biases tasks and thinking dispositions was associated with real‐life correlates in a community sample of adults. We examined performance on five heuristics and biases tasks (ratio bias, belief bias in syllogistic reasoning, cognitive reflection, probabilistic and statistical reasoning, and rational temporal discounting), three thinking dispositions (actively open‐minded thinking, future orientation, and avoidance of superstitious thinking), and a questionnaire assessing real‐world correlates in several domains (substance use, driving behavior, financial behavior, gambling behavior, electronic media use, and secure computing). Our heuristics and biases tasks and thinking disposition measures were modestly associated with several real‐world outcomes, including the domains of secure computing, financial behaviors, and the total scores. That is, better performance on the heuristics and biases measures was associated with fewer negative outcomes. We found that the associations were generally higher in males than in females. Heuristics and biases performance and thinking dispositions were unique predictors of real‐world outcomes after statistically controlling for educational attainment and sex differences. Copyright © 2016 John Wiley & Sons, Ltd.     

Correlates of Suicide Stigma and Suicide Literacy in the Community

Public knowledge and attitudes toward suicide may influence help‐seeking for suicidality. This study aimed to identify correlates of suicide attitudes and knowledge. Australian adults were invited to complete an online survey, with 1,286 responders. Less exposure to suicide, older age, male gender, less education, and culturally diverse backgrounds were associated with poorer knowledge; while younger age, male gender, and culturally diverse backgrounds were associated with more stigmatizing attitudes toward people who die by suicide. The results suggest suicide literacy and stigma reduction programs would benefit community members, particularly males and individuals from culturally diverse backgrounds.     

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.     

The Gender‐Specific Associations Between Religion/Spirituality and Suicide Risk in a Sample of Austrian Psychiatric Inpatients

Most studies have found religion/spirituality to be protective against suicide risk, with a stronger effect among women. To understand this effect, theories of suicide and clinical samples are needed, but related studies are lacking. We applied two established suicide models in 753 psychiatric inpatients. Religion/spirituality correlated protectively with components of the suicide models, with stronger associations among women. The protective effect emerged especially for the capability aspect of suicide among men and for the motivational aspect among women, suggesting very different causal mechanisms, but this has to be replicated with longitudinal studies.     

Suicide Attempt Risk in Youths: Utility of the Harkavy–Asnis Suicide Scale for Monitoring Risk Levels

The Harkavy–Asnis Suicide Scale (HASS), one of the few self‐report scales assessing suicidal behavior was evaluated and ideation, was evaluated and predictors of suicide attempts (SAs) were identified with the goal of developing a model that clinicians can use for monitoring SA risk. Participants were 131 pediatric emergency department (ED) patients with suicidal behavior. The HASS and Diagnostic Interview Schedule for Children (DISC‐IV) were administered approximately 2 months after ED presentation. When compared with DISC‐IV ratings, sensitivity of the HASS SA items was excellent (100%), and overall classification accuracy was 72%. SA planning was the strongest predictor of SAs.     

Coping With Remembrances of Parental Rejection in Childhood: Gender Differences and Associations With Intimate Partner Relationships

Grounded in interpersonal acceptance-rejection theory (IPARTheory), this exploratory study investigated a) major characteristics of affective copers and non-copers, b) the effects of acceptance by one parent insofar as it moderates rejection by the other parent, and c) the mediation effect of intimate partner relationships on the relation between remembered parental rejection and adults’ current psychological adjustment. The theory recognizes that the psychological adjustment of some adults who remember having been rejected by parents in childhood is not as seriously impaired as it is for the majority of individuals. These people are called affective copers in IPARTheory. The sample included 724 affective copers and 1121 non-copers, which are adults who remember having been rejected by their parents in childhood, and whose psychological adjustment is impaired in adulthood. Results of analyses revealed that for male affective copers, both maternal and paternal rejection were unique and significant predictors of adjustment, whereas for female copers, age and an interaction between remembrances of maternal and paternal rejection were significant predictors. For male non-copers, age, remembered parental rejection, and an interaction between maternal and paternal rejection were significant predictors of psychological adjustment. For female non-copers, in contrast, remembrances of both maternal and paternal rejection in childhood were significant predictors. Lastly, perceived partner acceptance-rejection mediated the relationship between remembered parental rejection in childhood and the psychological adjustment of non-copers, but not of affective copers. Results of this study inform the work of practitioners and prevention scientists working with adults who experienced serious rejection from their parents in childhood.