Purpose in life and reasons for living as mediators of the relationship between stress,coping, and suicidal behavior

Positive psychological factors that help protect vulnerable persons from suicidal behavior are vital in understanding resiliency and suicide prevention. The purpose of the current study was to examine whether positive factors (including purpose in life, reasons for living, and coping styles) mediate the relationship between stressful life events and suicidal behaviors among 416 college student volunteers. Reasons for living inversely predicted suicidal behavior and thoughts directly as well as indirectly via an inverse relationship with depression. Purpose in life indirectly predicted suicidal behavior and thoughts via an inverse effect on depression, whereas emotion-focused coping indirectly predicted suicidal behavior and thoughts both through an effect on depression and an inverse effect on reasons for living. In addition, avoidant coping indirectly predicted suicidal behavior via a direct, positive effect on reasons for living. Reasons for living and emotion-oriented coping had the largest effects in the model. Results of this study underscore the importance of augmenting reasons for living and purpose in life among suicidal or potentially suicidal persons.     

Relationship Between Religious Coping and Suicidal Behaviors Among African American Adolescents

This study investigated whether hopelessness and depression were risk factors for suicidal thoughts and behaviors in African American adolescents and looked at whether religious participation and religious coping protected these students from suicidality. Participants were 212 African American high school students (133 females, 79 males). The results of multiple and logistic regression analyses found that hopelessness and depression were risk factors for suicidal ideation and attempts. Religious coping style was significantly related to suicidal behaviors: Self-directed coping was related to increased hopelessness, depression, and suicide attempts, and collaborative coping was related to increased reasons for living. Gender differences were found in symptoms of depression, religious coping style and religious participation. Results provide additional support for suicide interventions to target hopelessness and depressive symptoms and highlight the importance of examining the role of culturally salient variables, such as religious participation and religious coping style, when developing intervention programs for suicide.     

Gender differences in the psychosocial correlates of suicidal ideation among adolescents.

Gender differences in the psychosocial correlates of suicidal ideation were studied. A sample of 613 high school students (ages 14-19) completed measures of suicidal ideation, depression, hopelessness, life stress, loneliness, alcohol and drug use, and reasons for living. The results of a discriminant function analysis indicated that males reported higher loneliness and substance abuse scores than females whereas females reported greater suicidal ideation, depression, and reasons for living. The results of multiple regression analyses found that, although the same four variables, depression, hopelessness, substance abuse, and few reasons for living emerged as significant predictors of suicidal ideation in both samples, the predictive equation accounted for more of the variance in ideation scores in females (57%) than in males (46%). In a final analysis a discriminant function analysis of the subscales of the reasons for living inventory revealed that females have a greater fear of death and injury whereas males have a greater fear of social disapproval over having suicidal thoughts. This may account for the greater rate of suicide completing among males. Fear of social disapproval, more anger and impulsivity, and less help-seeking behavior among males are offered as potential variables to explain the observed gender differences.     

The moderating effect of humor style on the relationship between interpersonal predictors of suicide and suicidal ideation

This study investigated how positive and negative humor styles relate to suicidal ideation, thwarted belongingness, and perceived burdensomeness. Analyses indicated that affiliative and self-defeating humor style moderated the relationships between thwarted belongingness and suicidal ideation as well as perceived burdensomeness and suicidal ideation when controlling for depression. The clinical importance of assessing and tracking humor styles as potential coping mechanisms against suicidal thinking is discussed.     

Using the Suicide Index Score to Predict Treatment Outcomes among Psychiatric Inpatients

For many suicidal people, the desire to die is moderated by a competing desire to live. This study aimed to demonstrate the ability of a wish‐to‐live versus wish‐to‐die index score to measure ambivalence and trichotomize suicidal inpatients into distinct stratified risk groups. Analyses revealed that index scores calculated for patients at treatment start significantly discriminated among the groups at index and uniquely predicted suicidal ideation, hopelessness, and depression scores across treatment. On average, patients with wish‐to‐live and wish‐to‐die orientations resolved suicidal ideation by discharge. Changes in suicidal ideation among ambivalently oriented patients were more variable. Clinical and research implications are discussed.     

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.     

Toward a predictive model of suicidal ideation and behavior: some preliminary data in college students

Within a multivariate statistical design, the relationship of various interpersonal, emotional, and cognitive variables to suicidal ideation and behavior in college students was examined. A total of 158 subjects (58 males, 100 females) completed self-report measures of life stress, faulty cognitions, loneliness, depression, hopelessness, family cohesiveness, adaptive reasons for living, and suicidal ideation and behavior. The results of a multiple-regression analysis, forward-inclusion algorithm, indicated that a predictive equation consisting of loneliness, irrational beliefs, and low adaptive reasons for living best accounted for suicidal behavior scores. To determine the basic structures and power of the predictor variables under study, a factor analysis and composite regression were employed, resulting in a predictive equation consisting of three factors: Social/Emotional Alienation, Cognitive Distortions, and Deficient Adaptive Resources. Results are discussed in terms of an interactional model of suicidal behavior.     

Relations Between Suicidal Ideation,Depression, and Emotional Autonomy from Parents in Adolescence

We examined the relations between depression, emotional autonomy quality-related constructs of separation and detachment, and suicidal ideation, focusing on the unique and common contribution that depression, separation and detachment made to suicidal ideation. We also examined gender differences. 403 adolescents, 196 boys and 207 girls, completed self-report measures of depression, separation and detachment, and suicidal ideation. The data showed a significant relation between depression and suicidal ideation both for boys and girls, and between detachment and suicidal ideation only for boys. Results for boys supported an additive model such that depression and detachment each contributed unique variance to boys’ suicidal ideation, and an interactive model such that detachment contributed to exacerbate the risk of suicidal ideation when boys were already at risk because of depression. The data for girls supported an interactive, but not additive, model such that depression and detachment did not contribute independently to girls’ suicidal ideation but in a joint way.     

Concurrent validity of a stress-vulnerability model of suicidal ideation and behavior: a follow-up study

A follow-up study to test the concurrent validity of a stress-vulnerability model of suicidal ideation and behavior was conducted. A total of 202 college students (139 females, 63 males) completed self-report measures of life stress, loneliness, depression, dysfunctional cognitions, reasons for living, hopelessness, current suicide ideation, and predictions of future suicide probability. The results of a multiple-regression analysis indicated that 30% of the variation in suicide ideation scores could be accounted for by the linear combination of negative life stress, depression, loneliness, and few reasons for living. The linear combination of current suicide ideation, hopelessness, dysfunctional cognitions, and few reasons for living explained 56% of the variance in self-predicted future suicide probability. The results are interpreted as being supportive of the proposed model.     

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.     

Low self‐esteem,entrapment, and reason for living: A moderated mediation model of suicidal ideation

Adolescent suicidal ideation has become a top public health concern. It is thus significant to explore both risk and protective factors of adolescent suicidal ideation. The present study tested a moderated mediation model of suicidal ideation in a sample of Chinese adolescents. Chinese adolescents of 1074 (54.2% females, aged between 11 and 18 years) completed questionnaires assessing self‐esteem, entrapment, reason for living, and suicidal ideation. We found that entrapment mediated the association between low self‐esteem and suicidal ideation. The association between entrapment and suicidal ideation was moderated by reason for living. Findings of this study may expand our understanding of the development of suicidal ideation, and facilitate future research exploring the interplay of risk and protective factors of suicidality. Clinical implications of these findings were also discussed.     

Racial differences in self-disclosure of suicidal ideation and reasons for living: implications for training

Racial differences in suicidal self-disclosure and reasons for living were investigated in 2 separate studies. In Study 1, a random sample of archival client and therapist intake data from a university counseling center for 1 year was examined, and results indicate that ethnic minority clients do not self-disclose suicidal ideation as readily as their nonethnic minority peers. In addition, a significantly higher number of ethnic minority clients were deemed "hidden ideators" because their suicidal ideation only became evident when a counselor performed a suicide risk assessment. Only 1 of the 36 ethnic minority clients with suicidal ideation in the sample voluntarily self-disclosed this ideation at intake without an assessment by the therapist. Study 2 used the Reasons for Living Inventory (RFL) and compared African American and European American college students from an introductory psychology course. The RFL is a useful instrument to compare potential race differences in reasons people report for choosing not to kill themselves, because it does not require respondents to self-disclose (or to have) current suicidal ideation. The results from Study 2 indicate European Americans report fewer reasons for choosing not to kill themselves than their African American peers and that African Americans scored significantly higher than European Americans on the moral objections and survival and coping beliefs subscales of the RFL. Implications for training counselors in suicide risk assessment, prevention, and treatment with ethnic minorities are discussed.     

Religiosity as a buffer against suicidal ideation: a comparison between Christian and Muslim-Arab adolescents

The majority of existing studies on the impact of religious beliefs on adolescents’ suicidal ideation have been conducted among Christians living in Western countries. This study explored the association between religious beliefs and suicidal thoughts among Muslim and Christian adolescents from the Arab minority population of the State of Israel. An estimated 219 late-adolescents participated in this study, including 110 Muslims and 99 Christians, with the same proportion of boys and girls. Participants completed questionnaires on reasons for living, suicidal ideation and religiosity. A significant negative correlation (r =??.33) was found between level of religiosity and suicidal ideation, but only among the Christian adolescents. Religious devoutness may not be a universal buffer against suicidal ideation, across different religions.     

Lesbian,gay, and bisexual suicidal behavior: testing a constructivist model

The present investigation surveyed 162 self-identified lesbian, gay, and bisexual individuals recruited from LGB-related social organizations or contacted through networking procedures with regard to suicidal behaviors, suicide risk factors, and reasons for living. Approximately 41% of the respondents indicated a serious consideration of suicide including the identification of a specific suicide plan (23%) or a past suicide attempt (36%) with significant intent to die (13%). Forty-six percent of the sample indicated at least some degree of chance of attempting suicide in the future. Grounded in the existential-constructivist theory of suicide (Rogers, 2001), empirically and theoretically identified suicide risk factors were found as a group to predict suicidal ideation (R2 = .16) and attempts (R2 = .17), with abuse-related items independently predicting both suicidal ideation (R2 = .03) and attempts (R2 = .08). Items related to self-identity issues and social acceptance were predictive of suicidal ideation (R2 = .04), while substance abuse was predictive of suicidal ideation (R2 = .05) and attempts (R2 = .13) for males only. The established factor structure of the Reasons for Living Inventory (Linehan et al., 1983) was not supported in the current data, suggesting that it may not be an appropriate measure of reasons for living with LGB individuals.     

Positive and Negative Expectations of Hopelessness as Longitudinal Predictors of Depression,Suicidal Ideation,and Suicidal Behavior in High‐Risk Adolescents

The relationship between hopelessness and depression in predicting suicide‐related outcomes varies based on the anticipation of positive versus negative events. In this prospective study of adolescents at elevated risk for suicide, we used two Beck Hopelessness Scale subscales to assess the impact of positive and negative expectations in predicting depression, suicidal ideation, and suicidal behavior over a 2‐ to 4‐year period. In multivariate regressions controlling for depression, suicidal ideation, and negative‐expectation hopelessness, positive‐expectation hopelessness was the only significant predictor of depressive symptoms and suicidal behavior. Clinical interventions may benefit from bolstering positive expectations and building optimism.     

The Emergence of Suicidal Ideation During the Post‐Hospital Treatment of Depressed Patients

There is a paucity of research on the emergence of suicidal ideation in recently hospitalized patients undergoing treatment for depression. As part of a larger clinical trial, patients (N = 103) with major depression without suicidal ideation at hospital discharge were followed for up to 6 months while receiving study‐related outpatient treatments. Fifty‐five percent reported the emergence of suicidal ideation during the outpatient period, with the vast majority (79%) exhibiting this problem within the first 2 months post‐discharge. Seventy percent of those reporting severe suicidality prior to hospitalization exhibited a reemergence of suicidal ideation post‐discharge. However, 29% without significant suicidality at the index hospitalization later developed suicidal ideation during the outpatient treatment period. A faster time to the emergence of suicidal ideation was predicted by both higher prehospitalization levels of suicidal ideation as well as greater depression severity at hospital discharge. Overall, rates of emergent suicidal ideation found in the current sample of recently hospitalized patients were higher than those reported in previous outpatient samples.     

The Interrelations of Agency,Depression, and Suicidal Ideation Among Older Adults

The high rates of suicide among older men are cause for concern, and have prompted the investigation of factors that might explain these elevated rates. The current research examined whether the gender role construct agency was associated with depression and suicidal ideation among older adults. The results, based on self‐report data from a sample of older Australian men (n = 69) and women (n = 90), indicated that depression mediated the relation between agency and suicidal ideation. In addition, for older men only, agency moderated the depression‐suicidal ideation relation. The results suggest that older adults, and particularly men, with low levels of agency should be the targets for interventions aimed at increasing levels of agency and improving mental health.     

青少年网络被欺负与自杀意念的关系:自尊和情绪应对方式的链式中介作用

为探讨青少年网络被欺负、自尊、情绪应对方式和自杀意念的关系,采用网络被欺负量表、自尊量表、中学生应对方式量表和自杀意念量表对来自湖北、河南、安徽三省六所高中的802名高一学生进行调查,结果发现：网络被欺负直接影响自杀意念,且存在三条间接路径：通过自尊的单独中介作用影响自杀意念;通过情绪应对方式的单独中介作用影响自杀意念;通过自尊和情绪应对方式的链式中介作用影响自杀意念。研究有助于了解青少年网络被欺负对自杀意念的影响机制,对预防以及减少青少年自杀行为具有一定的现实意义。     

Acculturative stress, depression, and suicidal ideation in Mexican immigrants

This study examined the relationship among acculturative stress, depression, and suicidal ideation in a sample of Mexican immigrants. Also examined were variables that predict depression and suicidal ideation. Multiple regression analyses revealed that acculturative stress significantly predicted depression and suicidal ideation and that family support, social support, religiosity, agreement with the decision to migrate, and expectations for the future were significant predictors of depression and suicidal ideation. The overall findings suggest that adult Mexican immigrants who experience elevated levels of acculturative stress may be at risk for experiencing critical levels of depression and suicidal ideation. The findings highlight the importance of using culturally relevant clinical methods when assessing and treating the depressed and potentially suicidal acculturating individual.     

Functional and dysfunctional impulsivity, depression, and suicidal ideation in a prison population

D. Lester (1993) was not able to show any association between dysfunctional impulsivity and suicidal ideation, but he did find a negative correlation between suicidal ideation and functional impulsivity. The correlation was weak and was not significant when depression was controlled for. Given the fact that college students were the participants in that study, the low correlations may have resulted from insufficient variance in the data. In the current study, data were collected from prisoners (half of whom had recently attempted suicide); correlations among the variables were stronger (but still quite low) than the correlations found in Lester's study. As expected, the association between dysfunctional impulsivity and suicidal ideation was stronger than that between functional impulsivity and suicidal ideation. However, consistent with Lester's study, these correlations were not significant when depression was controlled for. Results indicate that a direct association between impulsivity and suicidal ideation is unlikely.