Treating the Capability for Suicide: A Vital and Understudied Frontier in Suicide Prevention

Current efforts at suicide prevention center largely on reducing suicidal desire among individuals hospitalized for suicidality or being treated for related psychopathology. Such efforts have yielded evidence‐based treatments, and yet the national suicide rate has continued to climb. We propose that this disconnect is heavily influenced by an unmet need to consider population‐level interventions aimed at reducing the capability for suicide. Drawing on lessons learned from other public health phenomena that have seen drastic declines in frequency in recent decades (HIV, lung cancer, motor vehicle accidents), we propose that current suicidality treatment efforts trail current suicidality theories in their lack of focus on the extent to which individuals thinking about suicide are capable of transitioning from ideation to attempt. We summarize extant evidence for specific capability‐centered approaches (e.g., means safety) and propose other options for improving our ability to address this largely overlooked variable. We also note that population‐level approaches in this regard would represent an important opportunity to decrease risk in individuals who either lack access to evidence‐based care or underreport suicidal ideation, as a reduced capability for suicide would theoretically diminish the potency of suicidal desire and, in this sense, lower the odds of a transition from ideation to attempt.     

Expressive drawing ability in children with autism

The autistic impairments in emotional and social competence, imagination and generating ideas predict qualitative differences in expressive drawings by children with autism beyond that accounted by any general learning difficulties. In a sample of 60 5–19‐year‐olds, happy and sad drawings were requested from 15 participants with non‐savant autism and compared with those drawn by three control groups matched on either degree of learning difficulty (MLD), mental age (MA) or chronological age (CA). All drawings were rated by two artists on a 7‐point quality of expression scale. Contrary to our predictions, the drawings from the autistic group were rated similar to those of the MA and MLD groups. Analysis of the people and social content of the drawings revealed that although children with autism did not draw fewer people, they did draw more immature forms than mental age controls. Furthermore, there was tentative evidence that fewer social scenes were produced by the autism sample. We conclude that the overall merit of expressive drawing in autism is commensurate with their general learning difficulties, but the social/emotional impairment in autism affects their drawings of people and social scenes.     

Posttraumatic Stress Disorder Symptom Clusters and the Interpersonal Theory of Suicide in a Large Military Sample

Prior studies examining posttraumatic stress disorder (PTSD) symptom clusters and the components of the interpersonal theory of suicide (ITS) have yielded mixed results, likely stemming in part from the use of divergent samples and measurement techniques. This study aimed to expand on these findings by utilizing a large military sample, gold standard ITS measures, and multiple PTSD factor structures. Utilizing a sample of 935 military personnel, hierarchical multiple regression analyses were used to test the association between PTSD symptom clusters and the ITS variables. Additionally, we tested for indirect effects of PTSD symptom clusters on suicidal ideation through thwarted belongingness, conditional on levels of perceived burdensomeness. Results indicated that numbing symptoms are positively associated with both perceived burdensomeness and thwarted belongingness and hyperarousal symptoms (dysphoric arousal in the 5‐factor model) are positively associated with thwarted belongingness. Results also indicated that hyperarousal symptoms (anxious arousal in the 5‐factor model) were positively associated with fearlessness about death. The positive association between PTSD symptom clusters and suicidal ideation was inconsistent and modest, with mixed support for the ITS model. Overall, these results provide further clarity regarding the association between specific PTSD symptom clusters and suicide risk factors.     

Self-harm prevalence and ideation in a community sample of cis,trans and other youth

Abstract

Background: Trans youth have been reported to have high rates of self-harm, depression and bullying, and find it difficult to seek support. However, much of this research comes from gender identity clinics; non-clinical samples and those who reject gender binaries remain under-researched.

Aims: This study investigated the experiences of a community school-based sample of Trans, identifying youth, Other, and cis-gendered adolescents in relation to their experiences of low mood, bullying, associated support, self-harm ideation and peer-related self-harm.

Methods: An online survey was completed by 8440 13–17?year olds (3625 male, 4361 female, 227 Other, and 55 Trans).

Results: Trans and Other students had significantly higher rates of self-harm ideation and peer self-harm, in comparison to cis-gendered students. These Trans and Other students reported significantly higher rates of bullying and self-reported depression and significantly less support from teachers and staff at school, in fact these students did not know where to go to access help.

Discussion: This community sample confirms findings of high rates of self-harm ideation, self-reported depression and bullying for Trans youth as previously reported in clinic-based samples. However, by accessing a community sample, the salience of the category “Other” was established for young people today. While Other and Trans identified students both struggled to find support, those who identified as Trans were more likely to have been bullied, and have experienced self-reported depression and thoughts of self-harm. Thus, those who identify as transgender represent a high-risk group that needs targeted support within schools and by statutory and nonstatutory community services. Unpacking the category of Other would be beneficial for future research, as well as exploring resilience within this group and intersecting identities such as sexuality, Autism, or experiences such as earlier abuse.     

Social Memory of Preschool Girls and Boys

In two experiments, 40 female and 40 male preschoolers attending a day-care center were shown photographs of children attending the center, and were asked either to name each pictured child (recall condition) or to point to the picture of the child as the experimenter said the child's name (recognition condition). In both experiments, girls and boys did not differ significantly in the number of correct identifications on either the recall or recognition tasks. The results do not support Feldstein's (1976) conclusion that preschool girls show better social memory than preschool boys.