Loneliness predicts suicidal ideation and anxiety symptoms in long-term childhood cancer survivors

Background/ObjectiveLong-term childhood cancer survivors (CCS) are at risk for adverse late effects. However, not all of them are well understood. The present study addressed loneliness, a previously under-researched mental health risk in cancer survivor populations. We assessed the prevalence of loneliness and its impact on psychological symptoms over time. Method: A registry-based sample of N = 633 adult long-term CCS underwent medical and psychological assessments and took part in a follow-up survey 2.5 years later. Psychological symptoms (somatic, anxiety, depression symptoms, and suicidal ideation) were measured using the Patient Health Questionnaire. We calculated linear regression models of symptoms at follow-up to investigate the impact of loneliness over time (controlling for symptoms at baseline and relevant confounders). Results: Loneliness was reported by 17.70% of CCS. In multivariate linear regression analyses, loneliness was still predictive of more severe anxiety symptoms and suicidal ideation over two years later. Loneliness did not predict somatic and depression symptoms at follow-up (which increased with age). Conclusions: Loneliness affected a significant number of CCS and was a risk factor for persistent anxiety symptoms and suicidal ideation. The extent to which young cancer patients’ re-integration into society is successful could thus have important implications for well-being in adulthood.     

Loneliness and Suicidal Ideation in Drug‐Using College Students

The college years are marked by social changes and behavioral experimentation which may increase risk of suicidal ideation. We propose a novel pathway for the development of suicidal thoughts between two established suicide risk factors, loneliness and drug use, which have not been examined in a nonclinical sample. Data were collected from 207 undergraduate drug‐using students at a large southeastern university. As hypothesized, suicidal ideation was positively correlated with both loneliness (r = .40) and drug use (r = .29). After controlling for several demographic variables, social desirability, and anxiety sensitivity, drug use was tested as a potential mediator in the loneliness–suicidal ideation link using a single‐mediator model. Results indicated a significant indirect (mediated) effect of loneliness on suicidal ideation via drug use (ab = 0.09, 95% CI: 0.02–0.18), suggesting that loneliness may contribute to suicidal ideation through increased drug use among college students. Identification of and intervention with students reporting loneliness and drug use may be a promising suicide prevention strategy on college campuses.     

Blame attribution in sexual victimization

The current study explored how victims and third-parties attribute blame and perpetrator motivation for actual sexual victimization experiences. Although we do not assert that victims are responsible for perpetrators’ behavior, we found that some victims do not allocate all blame to their perpetrator. We sought to examine how victims and third-parties allocate blame in instances of actual completed and attempted sexual victimization and how they perceived perpetrator motivations. Victims of completed rape (n = 49) and attempted sexual assault (n = 91), and third-parties who knew a victim of sexual assault (n = 152) allocated blame across multiple targets: perpetrator, self/victim, friends, family, and the situation. Participants also described their perceptions of perpetrator’s motivation for the sexual assault. Victims tended to assign more blame to themselves than third-parties assigned to victims. Furthermore, victims perceived perpetrators as being more sexually-motivated than third-parties did, who viewed perpetrators as more power-motivated. Results suggest that perceptions of rape and sexual assault significantly differ between victims and third-party individuals who have never directly experienced such a trauma.     

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.     

Loneliness and Suicidal Risk in Young Adults: Does Believing in a Changeable Future Help Minimize Suicidal Risk Among the Lonely?

This study examined loneliness and future orientation as predictors of suicidal risk, namely, depressive symptoms and suicide ideation, in a sample of 228 college students (54 males and 174 females). Results of regression analyses indicated that loneliness was a significant predictor of both indices of suicidal risk. The inclusion of future orientation was found to significantly augment the prediction model of both depressive symptoms and suicide ideation, even after accounting for loneliness. Noteworthy, beyond loneliness and future orientation, the Loneliness × Future Orientation interaction term was found to further augment both prediction models of suicidal risk. Consistent with the notion that future orientation is an important buffer of suicidal risk, among lonely students, those with high future orientation, compared to low future orientation, were found to report significantly lower levels of depressive symptoms and suicide ideation. Some implications of the present findings for studying both risk and protective factors associated with suicidal risk in young adults are discussed.     

Cognitive and Interpersonal Vulnerability to Suicidal Ideation: A Weakest Link Approach

In contrast with traditional models of risk for suicidal ideation that combine multiple vulnerability components into one composite measure, weakest link perspectives posit that individuals are as vulnerable as their most vulnerable component (or “weakest link”). Such a perspective has been applied to depression, but has not been evaluated with respect to suicidal ideation. Thus, the goal of the present study was to apply a weakest link perspective to the study of suicidal ideation. We hypothesized that an individual’s “weakest link” among vulnerability components from the hopelessness theory (HT) and interpersonal psychological theory of suicide (IPTS) would interact with high levels of stress to predict increases in suicidal ideation over a 6-week period better than the traditional conceptualizations of HT or IPTS. Participants were 171 college students who completed measures of cognitive vulnerability, stress, and suicidal ideation twice over a period of 6 weeks. Bayesian regression analyses supported our hypotheses. The data fit the weakest link model using HT and IPTS components better than traditional conceptualizations of HT and IPTS. This study implies that weakest link models from depression may be useful in understanding which individuals are most vulnerable to experiencing suicidal ideation in the context of stress.     

The importance of distinguishing between harassment-only and assault military sexual trauma during screening

Extant research demonstrates that a history of military sexual trauma (MST) is associated with PTSD and depression diagnoses as well as heightened risk for suicidal ideation and death by suicide. Past studies of MST and its sequelae typically collapse harassment-only and assault MST screening items into a single response, recorded as positive or negative for a history of MST. It is presently unclear whether assault is associated with poorer mental health outcomes relative to harassment-only MST. Female service members/Veterans (n = 656) completed an online survey assessing history (present, absent) and type (harassment-only, assault) of MST, PTSD, depression, sexual satisfaction and function symptoms, as well as suicidal ideation. Findings revealed that those who reported a history of MST, and assault more specifically, were more likely to report higher PTSD symptoms and probable PTSD diagnosis, higher depression symptoms and probable depression diagnosis, worse sexual function and probable sexual function diagnosis, lower sexual satisfaction, and presence of suicidal ideation. Those who reported harassment-only MST also reported higher PTSD severity and probable PTSD diagnosis, but the magnitude of the association of harassment-only MST and PTSD severity relative to assault MST and PTSD severity was substantially lower. Findings suggest it is critical to distinguish between history and type of MST during screening as a combined screening item loses sensitivity to identify those at heightened risk for distress and dysfunction.     

Mediators of the Daily Hassles–Suicidal Ideation Link in African American Women

Depressive symptoms and hopelessness as mediators of the daily hassles–suicidal ideation link in low‐income African American women exposed to intimate partner violence (n = 100) were investigated. As hypothesized, daily hassles, depressive symptoms, and hopelessness were each significantly and positively associated with suicidal ideation. Moreover, the relation between daily hassles and suicidal ideation was, in part, accounted for by depressive symptoms and hopelessness. This study demonstrates the importance of assessing for the presence of these risk factors when determining the likelihood that an abused African American woman will consider suicide. The findings further highlight the value of designing and implementing interventions that target the reduction in depressive symptoms and hopelessness in abused African American women exposed to daily hassles to reduce their suicide risk.     

Youth suicide risk and sexual orientation

Using a broad suicide risk assessment (suicidal ideation, hopelessness, hostility) with 100 youth ages 17 to 19, this study examined the relationship between sexual orientation and youth suicide risk. Participants were compared across sexual orientation, as well as level of perceived external support, which may be a mitigating variable in suicide risk. The suicide risk demonstrated by sexual minorities in this study was no greater than that of their heterosexual peers. Youth who reported more external support demonstrated lower overall suicide risk and, specifically, lower levels of hostility, hopelessness, and suicidal ideation. The results indicated that suicide risk is not determined by demographic criteria alone, and may be influenced by psychosocial variables, such as support.     

Loneliness and solitude in adolescence: A confirmatory factor analysis of alternative models

The present study tested a four-factor model of adolescent loneliness and solitude that comprises peer-related loneliness, family loneliness, negative attitude toward solitude, and positive attitude toward solitude. Nine different instruments for a total of 14 scales and derivative subscales were completed by a sample of mid-adolescents (N = 534) from Grades 10 through 12 (aged 15–18 years) in the Dutch-speaking part of Belgium. As expected, the four-factor solution provided a better fit to the data than did alternative models that comprised just a single factor, or two and three factors. Use of the Loneliness and Aloneness Scale for Children and Adolescents (LACA) is recommended, because the instrument measures all four aspects of the model. Implications for current theories on adolescent loneliness and associated phenomena, such as adolescents’ attitude toward being on their own, are briefly discussed.     

Toward an integrative model of suicide attempt: a cognitive psychological approach.

Applying a cognitive approach, the purpose of the present study was to expand previous research on stress-vulnerability models of depression and problem-solving deficits, as it relates to suicide attempt. Structural equation modelling, involving latent variables, was used to evaluate (a) whether low self-esteem, a low sense of self-efficacy, loneliness, and divorce constituted vulnerability factors for the development of depression; (b) whether hopelessness and suicidal ideation mediated the relationship between depression and suicide attempt; and (c) whether problem-solving deficits mediated the relationship between the vulnerability factors and suicide attempt, separate from depression/hopelessness. A total of 123 individuals, aged 18-75 years, participated in the study (72 suicide attempters and 51 psychiatric outpatients with no history of suicidal behavior). The results indicated a two path model of suicide attempt. The first path began with low self-esteem, loneliness, and separation or divorce, which advanced to depression, and was further mediated by hopelessness and suicidal ideation which led to suicide attempt. The second path developed from low self-esteem and a low sense of self-efficacy and advanced to suicide attempt, mediated by a negative appraisal of one's own problem-solving capacity, and poor interpersonal problem-solving skills. The importance of addressing both depression/hopelessness, and problem-solving deficits when working with suicide attempters is noted.     

Sexual assault history and suicidal behavior in a national sample of women

This study examined demographic and psychosocial correlates of suicidal ideation and suicide attempts in women with histories of sexual assault in childhood and/or adulthood identified from a national sample of women. Multivariate analyses showed that women with histories of sexual assault in both childhood and adulthood reported significantly greater odds of lifetime suicide attempts, controlling for demographic factors and other psychosocial characteristics. As predicted, younger age (marginal), stressful life events (marginal), depression, PTSD, and alcohol dependence symptoms were also significantly associated with suicidal ideation. Furthermore, number of lifetime traumatic events and depression were each associated with lifetime odds of suicide attempts. Implications for studying the role of sexual trauma and other psychosocial factors in relation to women's suicidal behavior 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.     

Coping Card Usage can Further Reduce Suicide Reattempt in Suicide Attempter Case Management Within 3‐Month Intervention

This randomized controlled trial was designed to evaluate the effectiveness of using crisis coping cards (n = 32) in the case management of suicide prevention compared with case management without the use of coping cards (n = 32) over a 3‐month intervention period. The generalized estimating equation was used to examine the interaction effect between treatments and time on suicide risk, depression, anxiety, and hopelessness. Results indicated that subsequent suicidal behaviors, severity of suicide risk, depression, anxiety, and hopelessness were reduced more in the coping card intervention group compared to the case management only group. Moreover, for the survival curves of time to suicide reattempt, the coping card group showed a significantly longer time to reattempt than the case management only group at 2‐month and 3‐month intervention periods.     

Associations Between Sleep Hygiene and Insomnia Severity in College Students: Cross-Sectional and Prospective Analyses

Although a small number of studies characterized cross-sectional associations between sleep hygiene and insomnia severity, no prior study has examined their relationships prospectively. Further, the relationship between sleep hygiene and insomnia severity among college students has rarely been examined. This study examined the prevalence of diverse sleep hygiene behaviors and their associations with insomnia severity in two independent samples of college students from a cross-sectional (N = 548; mean age = 19; 59% female; 71% White) and a two-wave short-term prospective (N = 157; mean age = 19; 71% female; 76% White) study. A total of 12% to 13% of students reported clinically significant insomnia. On average, students reported frequent engagement in inconsistent sleep-wake schedules and lounging and worrying/thinking about important matters in the bed. Improper sleep scheduling, behaviors that promote arousal near bedtime, and uncomfortable sleeping environments were positively associated with cross-sectional insomnia severity. After controlling for other well-established risk factors, only improper sleep scheduling remained significant. Prospectively, baseline improper sleep scheduling predicted insomnia severity at a 2-month follow-up after controlling for baseline insomnia severity and other well-established risk factors. Together, findings suggest a potential unique role of improper sleep scheduling in insomnia among college students.     

Plurality and prevalence of sexual motivations in a sample of young francophone adults

IntroductionUnderstanding the motivations that lead to the adoption of sexual behaviors is of major interest to both the individual and public health.ObjectivesThis work (i) questions the reasons that lead students from two French universities to adopt sexual behaviors, (ii) examines the motivational similarities and differences between men and women, (iii) compare the results to data from north American subjects.MethodIn total, 657 subjects (526 women; 131 men, mean age: 22.6 years) were requested to take part in an online study investigating sexual behaviors. Reason for Having Sex Questionnaire (Meston & Buss, 2007), was used as a basis for the identification of sexual motivations.ResultOn average 53.05 different motivations led to the adoption of sexual behaviors. Significant differences of men/women were found between men and women (72% significant differences in p < 0.05) but mainly of small amplitude (d < 0.33: 58.33%). Men and women also differ in the structure of interrelations between motivations and by the role played by the different motivations. Overall, female motivational system is more sectorized and more organized than the male system, which seems more resilient (density of interrelations Men: 46.3%; women: 34.2%; distance between motivations: 5.44 vs. 3.86, p < 0.001, d = 2.07). Cultural comparisons showed significant differences of low to moderate amplitude between young adult students in France and those who come from North American universities. Gender differences in sexual motivations for sex were more marked in France than in the US.ConclusionOur results argue for a bio-psychosocial and systemic approach of sexual motivations. Theoretical, methodological and practical perspectives are envisaged.     

Investigating teacher and student effects of the Incredible Years Classroom Management Program in early elementary school

The present paper reports on the results of a cluster randomized trial of the Incredible Years® Teacher Classroom Management Program (IY-TCM) and its effects on early elementary teachers' management strategies, classroom climate, and students' emotion regulation, attention, and academic competence. IY-TCM was implemented in 11 rural and semi-rural schools with K-2 teachers and a diverse student sample. Outcomes were compared for 45 teachers who participated in five full day training workshops and brief classroom consultation and 46 control teachers; these 91 teachers had a total of 1192 students. A high level of teacher satisfaction was found and specific aspects of the training considered most valuable for early elementary teachers were identified. Hierarchical linear modeling indicated a statistically significant intervention effect on Positive Climate in the classroom (d = 0.45) that did not sustain into the next school year. No main effects on student outcomes were observed, although a priori moderator analyses indicated that students with elevated social-behavioral difficulties benefitted with regard to prosocial behavior (d = 0.54) and inattention (d = − 0.34). Results highlight potential benefits and limitations of a universal teacher training program for elementary students, and suggest strategies for future delivery of the IY-TCM program and areas for future research.     

Body appreciation,sexual relationship status,and protective sexual behaviors in women

The relationship between body appreciation and sexual risk reduction behavior in women is under-explored. This cross-sectional study examined the relationships between body appreciation, male condom use, and sexually transmitted infection (STI) testing among a community-based sample of women (n = 285). Logistic regression results revealed that after controlling for age, BMI, and sexual orientation, having more than one sexual partner moderated body appreciation and current male condom use (OR = 4.21, p < .01, CI = 1.510–11.726). Body appreciation was not a significant predictor of STI testing in the previous 12 months. This suggests that women with higher body appreciation may be more likely to engage in some protective sexual health behaviors. Interventions that seek to improve body appreciation instead of body size change such as weight loss or gain may encourage certain protective sexual behaviors in women.     

Self-objectification,body self-consciousness during sexual activities,and sexual satisfaction in college women

Few studies examine the mechanisms that link body image to sexual satisfaction in women. Using the tenets of objectification theory, this study investigated the relationships between body surveillance, body shame, body self-consciousness during sexual activities, and sexual satisfaction in an ethnically diverse sample of American female college students (N = 368), while controlling for relationship status and body mass index. Results based on self-report measures of these constructs suggested that body shame and body self-consciousness during sexual activity were negatively correlated with sexual satisfaction. Additionally, path analysis indicated that body surveillance predicted increased body self-consciousness during sexual activity, partially mediated by body shame. Body self-consciousness, in turn, predicted decreased sexual satisfaction. Overall, study findings highlight the negative consequences of body image concerns for women's sexual satisfaction.     

Effects of psychotherapy with people who have been sexually assaulted: A meta-analysis

This paper presents the results of a meta-analysis of the treatment outcome studies of different types of psychotherapeutic approaches for sexual assault victims experiencing PTSD or rape trauma symptoms. There were 15 outcome studies identified for inclusion in the meta-analysis dating from 1988–2005, and these studies comprised 25 treatment conditions. Separate meta-analyses were conducted according to study design (independent samples and repeated measures), in keeping with meta-analytic conventions. The overall results for the two meta-analyses were highly consistent, and effect sizes were in the large range for independent samples (g = .91) and repeated measures treatments (g = .90). Effects were maintained at follow-up from 6–12 months after treatment. Studies represented diverse treatment approaches, and most treatments were effective in improving outcome according to symptom reduction. A number of moderating variables were examined. Better outcomes were achieved with individual therapy compared to group approaches. The use of semi-structured approaches and homework techniques were positively related to the magnitude of effect size.