Is Veteran Status and Suicide Risk Assessed in Community Long‐Term Care? A Review of the States' Assessment Instruments

Given recent policy initiatives to address suicide risk among older persons and veterans, community‐based elder serving agencies may serve an important role in identifying and referring individuals at risk for suicide. A review of state‐level long‐term assessment instruments was conducted to determine whether veteran status and suicide are assessed. Data from forty‐three state's Units on Aging instruments were content analyzed. Results indicate that over two thirds of the states in this review included questions about suicide and veterans in their assessments, 69.8% and 67.4% respectively. Suicide risk among elders and veterans must be addressed at local, state, and federal levels so that concerted attention and oversight can be provided for matching elders to the services they need.     

Considerations Regarding Online Methods for Suicide‐Related Research and Suicide Risk Assessment

Frequent advances in technology provide new and exciting opportunities for conducting suicide research and suicide risk assessments. However, to the authors' knowledge, best practices for using technology, specifically the Internet, to conduct research protocols involving suicide risk assessments have not been examined. In research contexts, the use of technology for research on suicidal behavior and suicide risk assessment can offer benefits relative to other forms of data collection. These advantages, which include increased validity, feasibility, and efficiency, as well as improvements in data collection and management, are presented. Considerations regarding the implementation of an online system for suicide risk assessment as well as limitations and future directions are discussed.     

Hopelessness Predicts Suicide Ideation But Not Attempts: A 10‐Year Longitudinal Study

Hopelessness is one of the most commonly cited risk factors for suicidal behaviors. However, several retrospective studies suggest that hopelessness, while strongly correlated with suicide ideation, does not distinguish attempters from ideators without attempts. This study is the first to utilize a prospective design to disambiguate the relationship of hopelessness to ideation versus attempts. Participants were 142 depressed patients followed up over 10 years. Hopelessness and suicidality (ideation and attempts) were assessed using validated questionnaires and structured interviews. Both retrospective and prospective analyses revealed that hopelessness was higher among those reporting any suicidality (ideation or attempts) compared with nonsuicidal individuals. However, hopelessness failed to meaningfully distinguish attempters from ideators in both retrospective and prospective analyses. Taken together with results from previous studies, our findings suggest hopelessness is best conceptualized as a risk factor for suicide ideation but not progression from ideation to attempts.     

Marital Discord and Suicidal Outcomes in a National Sample of Married Individuals

Suicide is the tenth leading cause of death in the United States, with an average of 105 suicides committed daily. The association between marital discord and 12‐month prevalence of suicidal ideation and suicide attempt was studied in a population‐based sample of married adults (N = 1,384). Marital discord was significantly and positively associated with suicidal ideation and suicide attempt, and these associations remained significant when controlling for demographics and 12‐month prevalence of mood, anxiety, and substance use disorders. Results suggest that marital discord is an important correlate of suicidal outcomes and may be important to target in preventing and treating suicide.     

Emergency Department Youth Patients With Suicidal Ideation or Attempts: Predicting Suicide Attempts Through 18 Months of Follow‐Up

This prospective study of suicidal emergency department (ED) patients (ages 10–18) examined the timing, cumulative probability, and predictors of suicide attempts through 18 months of follow‐up. The cumulative probability of attempts was as follows: .15 at 6 months, .22 at 1 year, and .24 by 18 months. One attempt was fatal, yielding a death rate of .006. Significant predictors of suicide attempt risk included a suicide attempt at ED presentation (vs. suicidal ideation only), nonsuicidal self‐injurious behavior, and low levels of delinquent symptoms. Results underscore the importance of both prior suicide attempts and nonsuicidal self‐harm as risk indicators for future and potentially lethal suicide attempts.     

A Five‐Month Longitudinal Study of Psychache and Suicide Ideation: Replication in General and High‐Risk University Students

Shneidman's (1993) model of psychache as the cause of suicide was evaluated in a 5‐month longitudinal study of psychological pain and suicide ideation. Replicating across general (N = 683) and high‐risk undergraduates (N = 262), psychache was significantly associated with suicide ideation, and change in psychache was significantly associated with change in suicide ideation. For general suicide ideation and suicide preparation, these significant results were maintained even when depression and hopelessness were statistically controlled. This research is a unique contribution being the first large‐sample longitudinal study that evaluates and supports Shneidman's psychache causal model of suicidality in general and high‐risk groups.     

Evaluating the Interpersonal Needs Questionnaire: Comparison of the Reliability,Factor Structure,and Predictive Validity across Five Versions

Five versions of the Interpersonal Needs Questionnaire (INQ), a self‐report measure of perceived burdensomeness and thwarted belongingness, have been used in recent studies (including 10‐, 12‐, 15‐, 18‐, and 25‐items). Findings regarding the associations between perceived burdensomeness, thwarted belongingness, and suicidal ideation using different versions have been mixed, potentially due to differences in measurement scales. This study evaluated factor structure, internal consistency, and concurrent predictive validity of these five versions in three samples. Samples 1 and 2 were comprised of 449 and 218 undergraduates, respectively; Sample 3 included 114 adolescent psychiatric inpatients. All versions demonstrated acceptable internal consistency. The 10‐item version and 15‐item version demonstrated the best, most consistent model fit in confirmatory factor analyses. Both perceived burdensomeness and thwarted belongingness consistently predicted concurrent suicidal ideation on the 10‐item INQ only. Future research should consider using the 15‐item or 10‐item versions.