Self-discrepancy and suicidal ideation

The purpose of this study was to determine whether certain self-discrepancies predicted the extent to which individuals experienced suicidal ideation. The Selves Questionnaire (an idiographic measure of self-beliefs) was administered to 152 undergraduate participants, who also completed measures of hopelessness, depression, and suicidal ideation. Three kinds of self-discrepancies were associated with suicidal ideation: actual:ideal, actual:ought, and actual:ideal:future. Covariance structure analyses indicated a best-fitting model suggesting that, actual:ideal and actual:ideal:future self-discrepancies contribute to hopelessness, which in turn contributes to depression and suicidal ideation. The findings suggest that self-discrepancy, as a form of negative self-evaluation, may contribute to an individual's risk for suicidal ideation. Moreover, the findings point to an integration of self-discrepancy theory with hopelessness theory.     

An analysis of adolescent suicidal ideation

The purpose of this study was to investigate the predominant variables (i.e., hopelessness, depression, anxiety, negative life stress, family social climate, coping behaviors) theorized to be etiologically significant in the production of adolescent suicidal ideation. Subjects were 433 normal, midwestern high school students. ANOVAs revealed significant sex differences in level of suicidal ideation over the past year. Therefore, separate path analyses were conducted for males and females. Various statistical tests revealed that assumptions of path analysis were upheld by the male and female models that emerged. For males, levels of depression and family cohesiveness were found to have direct effects on the criterion. For females, levels of depression and trait anxiety were found to have direct effects on the criterion. The remaining significant variables in both models only indirectly affected the criterion. This paper is based on the dissertation research completed by the first author. Portions of the paper were presented at the 98th Annual Convention of the American Psychological Association (Boston, MA), August 1990. This study was funded in part by a University of South Dakota General Research Fund grant awarded to the second author.     

An integrative model of suicidal ideation

An integrative path model is presented that details the relationships among several demographic variables, life stress, depression, hopelessness, social support, and suicidal ideation. The sample consisted of 737 university students, 287 males and 450 females. Negative life stress was found to be a significant predictor of both depression and hopelessness, which, in turn, mediated the relationship between life stress and suicidal ideation. Contrary to previous findings, depression proved to be a better predictor of suicidal ideation than hopelessness. Findings also illustrated the importance of including social support measures in the model, as significant relationships were discovered between social support and both life stress and suicidal ideation. The model accounted for a total of 34% of the variance in suicidal ideation. Individual findings are interpreted; the ways in which they reflect on previous research, and future efforts, are discussed.     

Body image and suicidal ideation in adolescents

Data from 231 adolescents (mean age = 15.7, SD = 1.39) were collected from a public school setting in the United States. Participants completed several measures, including those assessing depression, hopelessness, past suicidal behavior, body image, and current suicidal ideation. It was hypothesized that depression, hopelessness, past suicidal behavior, and body image (a risk factor seldom examined) would significantly predict current suicidal ideation and that there would be gender differences for body image. Regression analyses indicated that all risk factors including body image were significant predictors of current suicidal ideation for the whole sample. For both males and females, body image offered a unique contribution to the measurement of suicide ideation above and beyond the other risk factors, with body attitudes/feelings being the strongest predictor. Results encourage the inclusion of body image as a variable in risk models for adolescent suicidal ideation, as it likely accounts for additional variance above and beyond traditional risk factors.     

Understanding suicidal ideation and assessing for risk

The UK government's health strategy, The Health of the Nation , included a target for reducing the population suicide rates by 15% over an 8-year period [Department of Health (1992), London: HMSO]. This thrust has been carried forward in subsequent work embodied in the ninth standard of the National Service Framework for Mental Health [Department of Health (1999), London: HMSO] and Safety First: FiveYear Report of the National Confidential Inquiry into Suicide and Homicide by People with Mental Illness [Department of Health (2001), London: HMSO]. A crucial aspect in reducing suicide rates is the accurate assessment of those who may be at risk to enable appropriate interventions to take place.While any person who wants to end his or her own life may find a way to do so, it is most important for the clinician to approach any potential suicide with the conviction that it is possible to prevent at least some suicides. This paper outlines best practice regarding the exploration and assessment of suicidal ideation and suicidal potential.     

Correlates of suicidal ideation among rural adolescents

This study examined potential predictors of suicidal ideation among a nonclinical, rural adolescent population. A sample of 76 male and female adolescents enrolled in a rural public high school completed a personal information form, a suicide information questionnaire, short forms of the Beck Depression Inventory and the Family Environment Scale, and the Life Events Checklist. A stepwise multiple regression suggested significant predictive relationships between magnitude of suicidal ideation and measures of family social climate (i.e., Organization, Conflict, Expressiveness, and Independence subscales from the Family Environment Scale--Short Form). Multivariate analyses of variance and a discriminant-function analysis revealed no significant sex differences.     

An empirical investigation of adolescent suicidal ideation.

Four hundred nine high school students were surveyed to determine the percentage who had experienced suicidal ideation. The sample was then divided into high- and low-suicidal-risk groups. High-risk subjects were found to have significantly poorer quality friendships, lower self-esteem, and had experienced more life stress in the previous year.     

Identifying outpatients with entrenched suicidal ideation following hospitalization

The purpose of this study was to identify outpatients who experience entrenched suicidal ideation following inpatient psychiatric hospitalization. Our findings suggest that the use of a suicidal ambivalence index score was helpful at discriminating those who reported significantly greater ratings of suicidal ideation across a 1-year period of time, whereas splitting patients based upon suicide attempt history yielded nonsignificant results. Similar findings resulted from a dimensional analytic approach, as well. Application of the suicidal ambivalence index may help administrators identify patients who require more intensive clinical services to resolve their suicidal ideation.     

Predicting suicidal ideation in high school students.

In a sample of 77 high school students, current suicidal ideation was predicted by depression, music preferences, and reasons for living scores.     

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.     

Drop-in suicide prevention group decreases suicidal ideation among Veterans

This study examined the effectiveness of a weekly, drop-in therapy support group designed for Veterans identified at increased risk for suicide. Veterans were identified as at risk for suicide and referred to the group following hospitalization on the inpatient psychiatric unit after an increase in suicidal ideation (SI), presentation to a provider with SI with a plan, or having made a suicide attempt. An archival chart review was performed on 359 patients who were referred to the Coping, Understanding, Support, and Prevention Group from 2009 through 2011. Documented risk of suicide was collected from the chart including: frequency of inpatient psychiatric hospitalization, visits to the emergency department or mental health walk in clinic for SI, reported SI in clinical notes, consults resulting from calls to the Veteran’s Crisis Line, and assignment or removal of suicide risk behavior flags in the electronic medical record, for a period of 12 months prior to referral to the group and for a period of 12 months after referral to the group. Negative binomial regression models found that Veterans attending the support group showed a significantly greater reduction in frequency of endorsing SI post-referral compared to those who did not attend the group. Results imply that offering Veterans an ongoing therapeutic group format to give and receive support from peers also struggling with suicide risk factors is an effective way to reduce suicide-related thoughts.     

Prevalence of suicidal ideation in patients with atopic dermatitis

The prevalence of suicidal ideation in patients with mild, moderate, and severe atopic dermatitis between the age of 15 to 49 years were 0.21%, 6%, and 19.6%, respectively. In addition, the prevalence of homicide-suicidal ideation in mothers or fathers of patients (aged 0-14 years) with mild, moderate, and severe atopic dermatitis were 0.11%, 0.35%, and 3.28%, respectively. These results indicate that patients with atopic dermatitis or even parents of patients with atopic dermatitis have high prevalence of suicidal ideation.     

Suicidal ideation versus suicidal obsession: a case report

This case report illustrates the relationship between stress and obsessive-compulsive disorder (OCD) by describing an unusual case of OCD sequelae following a suicide attempt. The patient is a 29-year-old married woman who suffered a major depressive episode without OCD and tried to commit suicide by drinking household cleaner. Following the attempt, violent obsessive thoughts of harming herself and others emerged along with avoidance behavior. After exposure therapy, there was a decrease in her obsessive thoughts, less anxiety, and no avoidance behavior. This report highlights not only the existence of "posttraumatic obsession" but also the importance of accurate interpretation of suicidal preoccupation, leading to the diagnosis of OCD rather then suicidal ideation secondary to depression.     

Mindfulness tempers the impact of personality on suicidal ideation

The Five Factor Model (FFM) domains of neuroticism and extraversion have consistently been related to suicidal ideation, such that individuals high in neuroticism or low in extraversion are at greater risk for suicidal thinking. The relationship between mindfulness and suicidal thoughts has not been empirically investigated in relation to personality. However, mindfulness has been shown to moderate the relationship between neuroticism and depression (Barnhofer, Duggan, & Griffith, 2011). The current study examined the relationship of the FFM domains, mindfulness, and suicidal ideation, and tested whether mindfulness would moderate the relationship between FFM domains and suicidal thinking. Results indicated that mindfulness weakened the relationship between neuroticism and suicidal ideation. Additionally, a strong negative relationship between suicidal ideation and extraversion was present at low levels of mindfulness. The possible importance of incorporating mindfulness practices in the prevention of suicidal thinking is discussed.     

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.     

Psychological and family factors associated with suicidal ideation in pre-adolescents

To assess the psychological and family factors associated with suicidal ideation in pre-adolescent children, we studied a sample of 361 students, average age 9 years old. Two groups were formed, on the basis of the presence (n = 34) or absence (n = 44) of suicidal ideation. Suicidal ideation was assessed with the Children's Depression Inventory and the Children's Depression Rating Scale-Revised. Depression, hopelessness, self-esteem, and perceived family environment were compared in both the suicidal ideation and the control groups. Students with suicidal ideation generally presented greater depressive symptoms and hopelessness, and lower self-esteem and family expressiveness, although there were differences both between sexes, and when the variable depression was controlled. Identifying these risk factors in pre-adolescents may have an impact on prevention of suicidal behavior at higher risk ages.     

Stress, self-esteem, and suicidal ideation in late adolescents

The relationships among stress, self-esteem, and suicidal ideation in late adolescents were examined in a group of college students. Multiple regression analysis indicated that both stress and self-esteem were significantly related to suicidal ideation; low self-esteem and stressful life events significantly predicted suicidal ideation. The hypothesis that self-esteem would moderate the effects of life stressors on suicidal ideation was supported at the .06 level. A significant minority of the sample indicated having thoughts severe enough to be classified as clinical suicidal ideation. In general, participants who had experienced negative life events in the 6 to 12 months prior to participating in the study had lower self-esteem than those who had similar stresses within the prior six months. However, the opposite was true for clinical suicidal ideators; those who experienced negative life stressors recently had lower self-esteem than those who experienced negative life events six months to a year in the past.