Child Abuse—Suicide Resilience Link in African American Women: Interpersonal Psychological Mediators

The interpersonal-psychological theory of suicidal behavior (IPTS) is an exemplary model for understanding the desire for suicidal behavior. As such, it is important to explore its applicability in ethnoracial minority groups at increasing risk for suicidal behavior, such as low-income, African American women. Guided by the IPTS, the current study used 5 parallel mediation models to examine if there are links between individual types of childhood abuse (physical, sexual, emotional) and suicide resilience, and between cumulative abuse (higher levels of abuse inclusive of all three types, more types of severe levels of abuse) and suicide resilience, and whether the three components of the model (thwarted belongingness, perceived burdensomeness, acquired capability for suicide) mediate these associations. In a sample of low-income, African American women (n = 179), higher levels of each of the 3 types of childhood abuse and cumulative abuse correlated with lower levels of suicide resilience. Parallel mediation analyses using bootstrapping techniques revealed that increased acquired capability for suicide mediated all 5 associations and perceived burdensomeness mediated 3 of the links (emotional abuse, cumulative abuse, and cumulative abuse–severe with suicide resilience). Attention is paid to the clinical implications of the findings in terms of attending to the acquired capability for suicide and suicide resilience in the assessment and treatment of low-income, suicidal, African American women.     

The Clustering and Contagion of Suicide

Two general types of suicide cluster have been discussed in the literature; roughly, these can be classified as mass clusters and point clusters. Mass clusters are media related, and the evidence for them is equivocal; point clusters are local phenomena, and these do appear to occur. Contagion has not been conceptually well developed nor empirically well supported as an explanation for suicide clusters. An alternative explanation for why suicides sometimes cluster is articulated: People who are vulnerable to suicide may cluster well before the occurrence of any overt suicidal stimulus, and when they experience severe negative events, including but not limited to the suicidal behavior of one member of the cluster, all members of the cluster are at increased risk for suicidality (a risk that may be offset by good social support).     

Perceived burdensomeness, fearlessness of death, and suicidality among deployed military personnel

The interpersonal-psychological theory of suicide posits that the interaction of three elements is required for lethal suicidal behaviors: the perception that one is a burden on others, the perception that one does not belong, and fearlessness about death combined with high pain tolerance (termed “acquired capability” for suicide). Although an ever expanding research base supports the theory, very limited data exist supporting the theory among military personnel, a group that has experienced a rapid increase in suicides during the past several years. The current study tests the interpersonal-psychological theory in two clinical samples of military personnel while deployed to Iraq: those seeking treatment for mild traumatic brain injury, and those seeking outpatient mental health treatment. In both samples, perceived burdensomeness and acquired capability were significantly associated with suicidality, as was their interaction term. Results partially support the interpersonal-psychological theory of suicide, and indicate that perceptions of burdensomeness combined with fearlessness about death are associated with increased suicidality among deployed military personnel.     

The relationship between violence and youth suicide indicators among Asian American and Pacific Islander youth

The literature documents a relationship between interpersonal violence and suicide. One tool used to understand interpersonal violence is the Power Wheel, developed from clinical experience and originally used in domestic violence education. We examine the relationship between Teen Power and Control Wheel domains and suicidal indicators (seriously considered suicide, made a suicide plan, and attempted suicide) among Asian American and Pacific Islander high school students, in terms of both victimization and perpetration. Data from a 2007 survey of two multi-ethnic high schools on the island of O'ahu, Hawai'i were used. The survey assessed interpersonal youth violence and a multitude of risk and protective factors. It found that females were significantly more likely to seriously consider suicide and attempt suicide, compared to males. There were no statistically significant differences in seriously considering suicide, making a suicide plan, and attempting suicide by ethnic group, employment status, or hours worked per week. Using the Wheel, we found that all dimensions for victimization and perpetration were associated with the three suicidal indicators. However, the magnitude of this association was dramatically higher for victims than for perpetrators. School- and healthcare-based prevention strategies should ensure that both suicide and violence intervention components are addressed. Professionals who work with youth should be trained to feel comfortable, confident, and competent in discussing suicide and violence, and be willing and capable to assess and intervene.     

Suicide lié au travail et prévention

Regarding social law, work-related suicide can be qualified as a professional risk, in particular as a work accident. It's the option chosen by case-law. The idea is to compensate: qualifying suicide as a work accident provides a social security compensation to the suicided employee's family and, in certain cases, the possibility to sue the employer. But, this case-law does not really question the prevention of the suicide before its commitment. In Labour law, the employer's obligation to prevent risks must face the risk of work-related suicide.     

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.     

A Brief Alcohol Intervention During Inpatient Psychiatric Hospitalization for Suicidal Adolescents

Alcohol use and suicide-related thoughts and behaviors are common in psychiatrically hospitalized adolescents and each problem can exacerbate the other. Despite knowledge about the functional relationship between alcohol use and suicide-related thoughts and behaviors, inpatient psychiatric units only cursorily address alcohol use because suicide risk is considered primary. In this paper we provide theoretical and empirical rationale for the inclusion of brief motivational interventions for alcohol use in inpatient treatment settings for suicidal adolescents. We give a case example of the brief intervention in practice, including when and how to use specific techniques. Following the case example, we discuss the flexibility of this intervention and how it can be adapted for adolescents with varying risk profiles. We conclude with recommendations for future research, including the development and testing of technology-based boosters following hospital discharge.