Life Stress,Social Support,and Problem-Solving Skills Predictive of Depressive Symptoms,Hopelessness, and Suicide Ideation in an Asian Student Population: A Test of a Model

The present study tested both a stress-problem-solving model and a stress-social support model in the etiology of depressive symptoms, hopelessness, and suicide ideation for a group of Asian international students in the United States. Problem-solving skills and social support were hypothesized as two mediators between life stress and depressive symptoms, hopelessness, and suicide ideation. The results from a series of stepwise regression analyses and a path analysis support the hypotheses, indicating that these models generalized to a sample of Asian international students. The roles of social support and problem-solving skills in depressive symptoms and hopelessness are discussed. The results also suggest that hopelessness may serve as a cognitive factor directly affecting depressive symptoms and indirectly affecting suicide ideation.     

An expanded etiological model for suicide behavior in adolescents: Evidence for its specificity relative to depression

This study tests both the stress/social support and the stress/problem-solving etiological models for suicidality while controlling for depression. To this end, a depressed, high-suicide-ideating sample (N=68) was compared to a depressed, low-suicide-ideating sample (N=64). Hierarchical multiple regression analyses were used to test the unique contributions of stress, problem-solving orientation, problem-solving skills, and perceived level of social support in predicting level of suicidality. Hierarchical regression analyses were also used to test the interactive contributions of problem-solving × stress and social support × stress in predicting level of suicidality. Regression models were generated separately for men, women, and the entire sample using all factors. The results clearly support the importance of social support as an independent predictor of suicidality for men, women, and the entire sample. Ability to generate alternatives to identified problems predicted suicidality, but only for women and the entire sample. Problem-solving orientation was not uniquely predictive of suicidality and may affect suicidal behavior via its relationship to depression.     

Social Problem-Solving and Suicidal Ideation Among Homeless Youth Receiving a Cognitive Therapy Intervention: A Moderated Mediation Analysis

Despite the high prevalence of suicidal ideation and attempts among homeless youth, little research has examined how suicide prevention interventions influence suicide-related risk and protective factors, and ultimately produce positive outcome in suicidality in this population. Drawing on the Diathesis-Stress Model and the Interpersonal Theory of Suicide, the current study examined whether participation in Cognitive Therapy for Suicide Prevention (CTSP) moderated the mediation link between social problem-solving, perceived burdensomeness and thwarted belongingness, and suicidal ideation among a sample of homeless youth experiencing suicidal ideation. Social problem-solving refers to a set of cognitive, emotional, and behavioral coping responses in the face of stressful situations, and it is identified as a potent protective factor in alleviating perceived burdensomeness and thwarted belongingness, and reducing suicidal ideation. Participants included 150 homeless youth (M age = 20.99, range = 18-24; 41% female) who were randomly assigned to Cognitive Therapy for Suicide Prevention (CTSP) + Treatment as Usual (TAU) (n = 75) or Treatment as Usual alone (n = 75). Participants were assessed at baseline, 3, 6, and 9 months post-baseline. Findings showed that perceived burdensomeness mediated the association of social problem-solving with suicidal ideation only among youth participating in the CTSP condition. These findings provide evidence to support the promising effects of CTSP in enhancing the protective effects of social problem-solving on suicidal ideation through the mediating effects of perceived burdensomeness. Findings also have implications for improving intervention effectiveness with a community-based population at high risk of suicide.     

The differential impact of brooding and reflection on the relationship between perceived stress and suicide ideation

This study investigated whether brooding and reflection moderated the relationship between perceived stress and suicide ideation. It was hypothesized that brooding, but not reflection, would strengthen the effect of perceived stress on suicide ideation above and beyond depression symptoms. Hypotheses were supported. Results suggest the assessment of a brooding response style may help identify clients who are more likely to contemplate suicide when confronted with life stress.     

The problem-solving diathesis in depression,hopelessness, and suicide ideation: A longitudinal analysis

The problem-solving deficit (PSD) diathesis-stress model of suicide behavior proposed by Clum, Patsiokas, and Luscomb (1979) and expanded by Schotte and Clum (1982, 1987) was examined in a short-term longitudinal test. The present study assessed the relationship between problem-solving deficits at Time 1—prior to the stressor (a D or F on a midterm examination)—and adjustment at Time 2—after the Stressor. Evidence was found for an additive predictive relationship for stress and problem-solving deficits to Time 2 measures of depressive symptoms, hopelessness, and suicide ideation. Evidence was also found that PSD × Stress interactions uniquely predicted the three criteria. The results of this study were taken as evidence of problem-solving deficits functioning as a diathesis for depression, hopelessness, and suicide ideation.     

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.     

Cultural orientation, family cohesion, and family support in suicide ideation and depression among African American college students

This study extends previous research by examining the role of communalism, family cohesion, and family support in suicide ideation and depression in African American college students. Participants were 188 African American introductory psychology students (126 female, 61 male) from a historically black college. (1) Results showed that communalism, family cohesion, and family support were positively associated with each other. Higher levels of family cohesion and family support were associated with lower levels of suicide ideation and depression. Linear regression analyses showed a main effect for communalism and family support. Having strong communal values was positively related to suicide ideation and depression. Having strong family support was associated with fewer experiences of suicide ideation and depression. Stepwise regression analyses indicated that family support explained more variance in suicide ideation and depression than family cohesion. Implications of these results for future research and practice are discussed.     

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.     

Suicide Risk across Latent Class Subgroups: A Test of the Generalizability of the Interpersonal Psychological Theory of Suicide

It remains unclear whether the Interpersonal Psychological Theory of Suicide (IPTS; Joiner, 2005 ) is generalizable to the population or holds more explanatory power for certain subgroups compared to others. The aim of this study was to (1) identify subgroups of individuals who endorsed suicide ideation in the past month based on a range of mental health and demographic variables, (2) compare levels of the IPTS constructs within these subgroups, and (3) test the IPTS predictions for suicide ideation and suicide attempt for each group. Latent class, negative binomial, linear, and logistic regression analyses were conducted on population‐based data obtained from 1,321 adults recruited from Facebook. Among participants reporting suicide ideation, four distinct patterns of risk factors emerged based on age and severity of mental health symptoms. Groups with highly elevated mental health symptoms reported the highest levels of thwarted belongingness and perceived burdensomeness. Tests of the IPTS interactions provided partial support for the theory, primarily in young adults with elevated mental health symptoms. Lack of support found for the IPTS predictions across the subgroups and full sample in this study raise some questions around the broad applicability of the theory.     

Group-based problem-solving therapy in self-poisoning females: A pilot study

Aims: The treatment of suicidal behaviour remains limited in efficacy. This pilot study assessed the effectiveness of a time-limited, group-based problem-solving therapy intervention compared with a treatment as usual control group, in females who self-poison. Method: A total of 18 clients were equally randomised to treatment or control groups. All clients were assessed using standardised questionnaires for depression, hopelessness, suicidal ideation and social problem-solving skills, at pre-treatment, post-treatment and two months follow-up. Results: The treatment group experienced significant reductions in levels of depression, hopelessness, suicidal ideation and improvements in self-assessed social problem-solving skills. Improvements in mental health and aspects of self-assessed problem-solving skills for the treatment group continued to be evident at two months follow-up. The control group did not change significantly over time on mental health measures or social problem solving abilities. Conclusion: Although limited by small sample size, the results suggest that group-based problem-solving therapy is effective in the management of deliberate self-poisoning. This paper is a unique contribution in that it examines the implementation of problem solving therapy with a homogenous population and in a group format. Methodological concerns and directions for future research are discussed.     

Dimensions of Religion Associated with Suicide Attempt and Suicide Ideation in Depressed,Religiously Affiliated Patients

There is substantial evidence to support the claim that religion can protect against suicide ideation, suicide attempts, and completed suicide. There is also evidence that religion does not always protect against suicidality. More insight is needed into the relationship between suicidal parameters and dimensions of religion. A total of 155 in‐ and outpatients with major depression from a Christian Mental Health Care institution were included. The following religious factors were assessed: religious service attendance, frequency of prayer, religious salience, type of God representation, and moral objections to suicide (MOS). Multiple regression analyses were computed. MOS have a unique and prominent (negative) association with suicide ideation and the lifetime history of suicide attempts, even after controlling for demographic features and severity of depression. The type of God representation is an independent statistical predictor of the severity of suicide ideation. A positive‐supportive God representation is negatively correlated with suicide ideation. A passive‐distressing God representation has a positive correlation with suicide ideation. High MOS and a positive‐supportive God representation in Christian patients with depression are negatively correlated with suicide ideation. Both are likely to be important markers for assessment and further development of therapeutic strategies.     

Longitudinal Relationships Between Positive Affect,Loneliness, and Suicide Ideation: Age‐Specific Factors in a General Population

The aims of this study were to analyze whether positive and negative affect, social support, and loneliness are factors longitudinally related to suicide ideation in the general population in different age groups. A total of 2,392 individuals from a nationally representative sample of the Spanish general population were evaluated in 2011–2012 and in 2014–2015. After including relevant control variables in the analyses, lower positive affect was prospectively related to ideation in 18‐ to 59‐year‐old individuals, whereas feelings of loneliness were related to ideation in 60‐year‐and‐older individuals. Social support was not associated with suicide ideation in any age group. These results are in line with the need for age‐tailored suicide prevention programs. The present findings might also suggest that health care professionals should consider feelings of loneliness rather than social support to assess the presence of suicide ideation in older people.     

Thwarted belongingness and perceived burdensomeness: construct validity and psychometric properties of the Interpersonal Needs Questionnaire

The present study examined the psychometric properties and construct validity of scores derived from the Interpersonal Needs Questionnaire (INQ) using latent variable modeling with 5 independent samples varying in age and level of psychopathology. The INQ was derived from the interpersonal theory of suicide and was developed to measure thwarted belongingness and perceived burdensomeness-both proximal causes of desire for suicide. Results support that thwarted belongingness and perceived burdensomeness are distinct but related constructs and that they can be reliably measured. Further, multiple-group analyses were consistent with invariance for young versus older adults and nonclinical versus clinical populations, thereby supporting the relevance of these constructs to diverse populations. Finally, both constructs demonstrated convergent associations with related interpersonal constructs-including loneliness and social support for belongingness and social worth and death ideation for burdensomeness--as well as prospective associations with suicidal ideation.     

Relation between social problem-solving ability and subsequent level of psychological stress in college students.

A prospective design was used to examine the relation between social problem-solving ability and later psychological stress in college students during the first semester of the academic year. A new social problem-solving inventory measured not only general ability, but also more specific components of the problem-solving process (e.g., problem orientation, problem-solving skills; D'Zurilla & Nezu, 1990). The results of a hierarchical multiple regression analysis showed that general problem-solving ability was negatively related to later stress, even after prior stress level and number of life problems were controlled. More specific analyses indicated that subjects' problem orientation was a better predictor of stress than their problem-solving skills. Results are discussed in terms of the possible stress-reducing effects of perceived control and successful problem resolution.     

Social-Cognitive Moderators of the Relationship between Peer Victimization and Suicidal Ideation among Psychiatrically Hospitalized Adolescents

Peer victimization among children and adolescents is a major public health concern, given its widespread individual and societal ramifications. Victims of peer aggression often face significant levels of psychological distress and social difficulties, such as depression, suicidal ideation, suicide attempts, and social rejection. The purpose of this study was to examine whether cognitive distortions and perceptions of social support moderate the association between peer victimization and suicidal thoughts among psychiatrically hospitalized adolescents. Participants included 183 psychiatrically hospitalized adolescents (ages 13 to 18). In multiple regression analyses that controlled for gender, social and cognitive factors served as significant resource factors. Cognitive factors also moderated the relationship between peer victimization and suicidal ideation.     

Purpose in Life, Satisfaction with Life, and Suicide Ideation in a Clinical Sample

This study examined the role of purpose in life and satisfaction with life in protecting against suicide ideation in a clinical psychiatric sample. Forty-nine psychiatric patients completed self-report measures of suicide ideation, purpose in life, satisfaction with life, neuroticism, depression, and social hopelessness. Zero-order correlations indicated significant associations between suicide ideation and the various predictors, in the hypothesized directions. Regression analyses illustrated that purpose in life and satisfaction with life accounted for significant additional variability in suicide ideation scores above and beyond that accounted for by the negative psychological factors alone. Purpose in life also mediated the relation between satisfaction with life and suicide ideation and moderated the relation between depression and suicide ideation. These findings demonstrate the potential value of attending to both resilience and pathology when building predictive models of suicide ideation and of attending to key existential themes when assessing and treating suicidal individuals.     

Source, recency, and degree of stress in adolescence and suicide ideation

This study sought to identify factors related to stress that predict suicide ideation among adolescents. The sample consisted of 425 students aged 14 to 18 years. Multiple regression analysis revealed that recency and degree of stress were significant in the prediction of degree and recency of suicide ideation. The implications of these and other findings for prevention and intervention (e.g., health education, parent workshops, and adolescent support groups) are discussed.     

Suicide ideation and depression in university students in Botswana

The study aimed at exploring suicide ideation and its relationship to depression in university students in Botswana. Data were collected from 122 undergraduate students (68.9% females, 31.1% males) with a mean age of 20.02 years. Depressive symptoms were measured with an adapted version of Beck's Depression Inventory-II. In total, 47.5% of the respondents reported suicide ideation, 28.7% reported previous suicide attempts, and the mean depression score was 19.14. Suicide ideation correlated strongly with total depression scores. The level of depression severity was linearly related to suicide ideation but 14.3% of respondents who scored at the level of minimal depression and 53.8% of those who scored at the level of mild depression had also contemplated suicide. The level of education of respondents’ mothers had an inverse relationship with suicide ideation and with depression in that those whose mothers had a tertiary level education were less likely to engage in suicide ideation and had significantly lower depression scores. The results are discussed from within the specific social ecological context of Botswana.     

The Interplay Among Risk Factors for Suicidal Ideation and Suicide: The Role of Depression, Poor Health, and Loved Ones' Messages of Support and Criticism

When individuals who receive social support are in poor physical or mental health and are criticized or made to feel unwanted, they may perceive themselves as a burden. Poor physical health and depression were hypothesized to exacerbate the harmful effects on suicidal ideation of receiving critical negative messages and of receiving social support. These hypotheses were tested using secondary analyses of data from a sample of 533 unemployed married individuals who were assessed shortly after job loss, and 6 months later. The results of our analyses supported the hypotheses and demonstrated that for participants with poor health or high level of depressive symptoms an increase in critical messages and social support (from Time 1 to Time 2) predicted increased suicidal ideation. This relationship was not observed for non- depressed participants in good health. The results are discussed in terms of their implications for suicide prevention.     

Race,Offense Type,and Suicide Ideation: Tests of the Interpersonal‐Psychological Theory in Juvenile Offenders

This study evaluated the synergy hypothesis of the Interpersonal‐Psychological Theory of Suicide (IPTS ), which argues thwarted belongingness and perceived burdensomeness are positively interactive in their association with suicide ideation, in a group of juvenile offenders. It also examined whether this prediction is differentially applicable across race/ethnicity or offense type. Participants included 590 adjudicated and confined male juveniles. Regression was used to test the association between suicide ideation and thwarted belongingness, perceived burdensomeness, and their interaction term. Subsequent analyses included tests of group interactions related to race/ethnicity and offense type. No interaction between thwarted belongingness and perceived burdensomeness was observed, despite adequate power. No significant group interactions were observed for race/ethnicity or offense type. However, results did show significant linear relationships between thwarted belongingness, perceived burdensomeness, and ideation, highlighting their potential utility as intervention targets in this at‐risk population. Thus, although the current results are the first to show the basic IPTS risk factors generalize across race/ethnicity and offense type, they also failed to support that those factors were interactive, a primary IPTS claim. The absence of an interaction between thwarted belongingness and perceived burdensomeness suggests their role in suicide ideation for juvenile offenders may be more parsimonious than the IPTS proposes.