Trajectories of Suicidal Ideation from Sixth through Tenth Grades in Predicting Suicide Attempts in Young Adulthood in an Urban African American Cohort

The trajectory of suicidal ideation across early adolescence may inform the timing of suicide prevention program implementation. This study aimed to identify developmental trajectories of suicidal ideation among an urban cohort of community‐residing African Americans (AA) longitudinally followed from middle school through early adulthood (ages 11–19 years). Subtypes based on the developmental course of suicidal ideation from late childhood through mid‐adolescence were identified using longitudinal latent class analysis (LLCA) with 581 AA adolescents (52.7% male; 71.1% free or reduced school meals). The developmental trajectories of suicidal ideation were then used to predict suicide attempts in young adulthood. Our LLCA indicated two subtypes (i.e., ideators and nonideators), with 8% of the sample in the ideator class. This trajectory class shows a peak of suicidal ideation in seventh grade and a steady decline in ideation in subsequent grades. Additionally, suicidal ideation trajectories significantly predicted suicide attempt. Results of these analyses suggest the need for suicide prevention approaches prior to high school for AA youth.     

The Incremental Utility of Emotion Regulation But Not Emotion Reactivity in Nonsuicidal Self‐Injury

This study assessed the incremental utility of emotion reactivity and emotion regulation in relation to nonsuicidal self‐injury (NSSI). Participants included 379 college students aged 18–22 who completed self‐report measures of emotion regulation, emotion reactivity, and NSSI. Emotion regulation was significantly related to NSSI both ignoring and controlling for reactivity, but the reverse was not true. Participants' use of NSSI for affect regulation appeared to moderate this relation. Findings support emotion regulation deficits as a target for intervention over and above heightened emotion reactivity, especially in those who use NSSI to regulate negative affect.     

What Factors Determine Disclosure of Suicide Ideation in Adults 60 and Older to a Treatment Provider?

Correlates of patient disclosure of suicide ideation to a primary care or mental health provider were identified. Secondary analyses of IMPACT trial data were conducted. Of the 107 patients 60 years of age or older who endorsed thoughts of ending their life at least “a little bit” during the past month, 53 indicated they had disclosed these thoughts to a mental health or primary care provider during this period. Multiple logistic regression was used to identify predictors of disclosure to a provider. Significant predictors included poorer quality of life and prior mental health specialty treatment. Among participants endorsing thoughts of suicide, the likelihood of disclosing these thoughts to a provider was 2.96 times higher if they had a prior history of mental health specialty treatment and 1.56 times higher for every one‐unit decrease in quality of life. Variation in disclosure of thoughts of suicide to a mental health or primary care provider depends, in part, on patient characteristics. Although the provision of evidence‐based suicide risk assessment and guidelines could minimize unwanted variation and enhance disclosure, efforts to routinize the process of suicide risk assessment should also consider effective ways to lessen potential unintended consequences.     

项安世卦变说新探

卦变说是理解项安世易说的关键,其卦变说接续了李挺之的相关识见,分反对卦与不反对八卦。反对卦皆自消息卦来,不反对卦皆自坎离来。以坎离作为主变之卦,既是对汉代易学重视坎离传统的接续,又融合了丹道思想,更是对当时理学家体用思想的认同与接纳,这使得项氏卦变说既具有深厚的传统积淀又有鲜明的时代认同。项氏卦变说的理论动机是从易象本身开显易道之变易,以弥补程颐仅从义理一面揭示易道变易之不足。     

Preventing Suicide at Suicide Hotspots: A Case Study from Australia

The Gap Park Self‐Harm Minimisation Masterplan project is a collaborative attempt to address jumping suicides at Sydney's Gap Park through means restriction, encouraging help‐seeking, and increasing the likelihood of third‐party intervention. We used various data sources to describe the Masterplan project's processes, impacts, and outcomes. There have been reductions in reported jumps and confirmed suicides, although the trends are not statistically significant. There has been a significant increase in police call‐outs to intervene with suicidal people who have not yet reached the cliff's edge. The collaborative nature of the Masterplan project and its multifaceted approach appear to be reaping benefits.     

Shame,Guilt, and Suicide Ideation among Bondage and Discipline,Dominance and Submission,and Sadomasochism Practitioners: Examining the Role of the Interpersonal Theory of Suicide

To date, no study has examined rates of suicide ideation or theory‐based risk factors for suicide ideation among bondage and discipline, dominance and submission, and sadomasochism (BDSM) practitioners. Participants were 321 adults that endorsed BDSM involvement. Thirty‐seven percent of the sample indicated a nonzero level of suicide ideation. Thwarted belongingness and perceived burdensomeness (PB) were positively associated with suicide ideation and their interactive effect predicted additional variance in suicide ideation after adjusting for depressive symptoms. Overall, shame and guilt were positively associated with suicide ideation and these relations were mediated by thwarted belongingness and PB in parallel adjusting for depressive symptoms; however, there were some differences between demographic subgroups. Among BDSM practitioners, stigma‐related internalized feelings (i.e., shame and guilt) may be associated with increased thwarted belongingness and PB, which are associated with suicide ideation.     

Suicidality,Self‐Harm,and Body Dissatisfaction in Transgender Adolescents and Emerging Adults with Gender Dysphoria

Prevalence of suicide attempts, self‐injurious behaviors, and associated psychosocial factors were examined in a clinical sample of transgender (TG) adolescents and emerging adults (n = 96). Twenty‐seven (30.3%) TG youth reported a history of at least one suicide attempt and 40 (41.8%) reported a history of self‐injurious behaviors. There was a higher frequency of suicide attempts in TG youth with a desire for weight change, and more female‐to‐male youth reported a history of suicide attempts and self‐harm behaviors than male‐to‐female youth. Findings indicate that this population is at a high risk for psychiatric comorbidities and life‐threatening behaviors.     

Assessing Motivations for Suicide Attempts: Development and Psychometric Properties of the Inventory of Motivations for Suicide Attempts

This study describes the psychometric properties of the Inventory of Motivations for Suicide Attempts (IMSA). The IMSA was designed to comprehensively assess motivations for suicide emphasized by major theories of suicidality. The IMSA was administered to two samples of recent suicide attempters, undergraduates (n = 66) and outpatients (n = 53). The IMSA exhibited a reliable two‐factor structure in which one factor represented Intrapersonal motivations related to ending emotional pain, and the second represented Interpersonal motivations related to communication or help‐seeking. Convergent validity and divergent validity of IMSA scales were supported by expected patterns of correlations with another measure of suicide motivations. In addition, the IMSA scales displayed clinical utility, in which greater endorsement of intrapersonal motivations was associated with greater intent to die, whereas greater endorsement of interpersonal motivations was associated with less lethal intent and greater likelihood of rescue. Findings suggest the IMSA can be of use for both research and clinical purposes when a comprehensive assessment of suicide motivations is desired.     

Suicide Risk Among Wounded U.S. Service Members

The association between suicide and combat injuries sustained during the wars in Iraq and Afghanistan was examined. A retrospective population‐based cohort design was conducted using official military records to identify combat injuries (October 7, 2001, to December 31, 2007). Those who were injured during combat had higher crude suicide rates than those who deployed and were not injured (incidence rate ratio [IRR] = 1.50; confidence interval [CI] = 1.06, 2.12), or never deployed (IRR = 1.46; CI = 1.04, 2.06). After adjusting for demographics, these findings were no longer statistically significant. Although our data did not support an elevated suicide risk among wounded service members, additional research is needed to examine the impact of injury severity.