James A. Naifeh PhD  Matthew K. Nock PhD  Robert J. Ursano MD  Patti L. Vegella MS  Pablo A. Aliaga MS  Carol S. Fullerton PhD  Ronald C. Kessler PhD  Christina L. Wryter BA  Steven G. Heeringa PhD  Murray B. Stein MD  MPH  the Army STARRS Collaborators 《Suicide & life-threatening behavior》2017,47(5):589-602

This prospective cohort study used administrative data from the Army Study to Assess Risk and Resilience in Servicemembers to examine associations between neurocognitive functioning and subsequent suicidal events among Regular Army enlisted soldiers during the years 2004–2009. Cases were all soldiers who completed the Army's Automated Neuropsychological Assessment Metrics (ANAM) computerized testing battery prior to documented suicide attempt (n = 607), ideation (n = 955), or death (n = 57). Controls were an equal‐probability sample of 9,893 person‐months from other soldiers. Exploratory factor analysis of five ANAM tests identified a general neurocognitive factor that excluded the mathematic processing test (MTH). When examined separately in logistic regression analyses that controlled for sociodemographics and prior mental health diagnosis, both the general neurocognitive factor (logit [β] = ?.197 to ?.521; p < .01) and MTH (β = ?.024 to ?.064; p < .05) were associated with all outcomes. When both predictors were examined simultaneously, the general neurocognitive factor continued to be associated with all outcomes (β = ?.164 to ?.417; p < .05) and MTH continued to be associated with suicide attempt (β = ?.015; p = .046) and ideation (β = ?.014; p = .018). These small but robust associations suggest that future research must continue to examine the extent to which objective neurocognitive tests may enhance understanding and prediction of suicide risk.  相似文献   

    

Kenneth L. Cox MD  MPH  Matthew K. Nock PhD  Quinn M. Biggs PhD  MPH  Jennifer Bornemann MSSW  Lisa J. Colpe PhD  MPH  Catherine L. Dempsey PhD  MPH  Steven G. Heeringa PhD  James E. McCarroll PhD  MPH  Tsz Hin Ng MPH  Michael Schoenbaum PhD  Robert J. Ursano MD  Bailey G. Zhang MS  David M. Benedek MD  the Army STARRS Collaborators 《Suicide & life-threatening behavior》2017,47(3):257-265

Debate continues about the accuracy of military suicide reporting due to concerns that some suicides may be classified as accidents to minimize stigma and ensure survivor benefits. We systematically reviewed records for 998 active duty Army deaths (510 suicides; 488 accident, homicide, and undetermined deaths; 2005‐2009) and, using research criteria, reclassified 8.2% of the nonsuicide cases to definite suicide (1), suicide probable (4), or suicide possible (35). The reclassification rate to definite suicide was only 0.2% (1/488). This low rate suggests that flagrant misclassification of Army deaths is uncommon and surveillance reports likely reflect the “true” population of Army suicides.  相似文献   

    

Marek S. Kopacz MD  PhD  Jason A. Nieuwsma PhD  George L. Jackson PhD  MHA  Jeffrey E. Rhodes DMin  William C. Cantrell MDiv  Mark J. Bates PhD  Keith G. Meador MD  ThM  MPH 《Suicide & life-threatening behavior》2016,46(2):206-212

Chaplains play an important role in supporting the mental health of current and former military personnel; in this study, the engagement of Department of Veterans Affairs (VA), Army, Navy, and Air Force chaplains with suicidality among their service users were examined. An online survey was used to collect data from 440 VA and 1,723 Department of Defense (DoD) chaplains as part of the VA/DoD Integrated Mental Health Strategy. Differences were noted for demographics, work setting characteristics, encountering suicidality, and self‐perceived preparation for dealing with suicidality. Compared to DoD chaplains, VA chaplains encounter more at‐risk service users, yet feel less prepared for dealing with suicidality.  相似文献   

    

Namkee G. Choi PhD  C. Nathan Marti PhD  Yeates Conwell MD 《Suicide & life-threatening behavior》2016,46(3):323-336

Previous study findings of psychotherapy's effect on suicide prevention have been inconsistent. This study reports the results of secondary analyses of outcome data from a short‐term depression treatment on reducing death/suicidal ideation among 158 low‐income homebound adults aged 50+. The treatment, in‐person or telehealth problem‐solving therapy (PST), compared with telephone support call, has been found effective in reducing depressive symptoms and disability among participants. Compared with support call participants, tele‐PST participants, but not in‐person PST participants, exhibited lower ideation ratings across the follow‐up period. Effect sizes at 36 weeks were 0.31 for tele‐PST and 0.17 for in‐person PST. Hopelessness mediated the effect of tele‐PST but not in‐person PST; however, in‐person PST also alleviated hopelessness, which led to lower ideation. Clinical implications of the findings are discussed.  相似文献   

    

Shirley Yen PhD  Kevin Kuehn BS  Caitlin Melvin BA  Lauren M. Weinstock PhD  Margaret S. Andover PhD  Edward A. Selby PhD  Joel B. Solomon MD  Anthony Spirito PhD 《Suicide & life-threatening behavior》2016,46(1):13-22

Prospective predictors of persistent nonsuicidal self‐injury (NSSI) were examined in adolescents admitted to an inpatient psychiatric unit for suicidal behaviors and followed naturalistically for 6 months. Seventy‐one (77%) participants reported NSSI at baseline, and 40 (56%) persisted at the 6 month follow‐up. Those who endorsed automatic positive reinforcement (APR) as the predominant reason for NSSI were more likely to persist in NSSI. Depression over follow‐up, but not at baseline, also predicted persistence. These results suggest that helping high‐risk adolescents to identify alternative ways of generating emotion(s) to counter the effects of APR that may accompany NSSI should be a high priority treatment target.  相似文献   

    

Brian L. Mishara PhD  Marc Daigle PhD  Cécile Bardon PhD  François Chagnon PhD  Bogdan Balan MD  PhD  Sylvaine Raymond MA  Julie Campbell MA 《Suicide & life-threatening behavior》2016,46(5):577-587

Research since the 1960s has consistently found that lay volunteers are better at helping suicidal callers than professionals. Yet, professional degrees are increasingly becoming requirements for helpline workers. In our first study, we conducted post hoc comparisons of U.S. helplines with all professional paid staff, all lay volunteers, and a mix of both, using silent monitoring and standardized assessments of 1,431 calls. The volunteer centers more often conducted risk assessments, had more empathy, were more respectful of callers, and had significantly better call outcome ratings. A second study of five Quebec suicide prevention centers used silent monitoring to compare telephone help in 1,206 calls answered by 90 volunteers and 39 paid staff. Results indicate no significant differences between the volunteers and paid employees on outcome variables. However, volunteers and paid staff with over 140 hours of call experience had significantly better outcomes. Unlike the United States, Quebec paid employees were not required to have advanced professional degrees. We conclude from these results and previous research that there is no justification for requiring that suicide prevention helpline workers be mental health professionals. In fact, the evidence to date indicates that professionals may be less effective in providing telephone help to suicidal individuals when compared to trained lay volunteers.  相似文献   

    

Lindsay A. Taliaferro PhD  MPH  Jennifer J. Muehlenkamp PhD  Joel Hetler PhD  LP  Glenace Edwall PhD  PsyD  Catherine Wright MS  LPCC  Anne Edwards MD  Iris W. Borowsky MD  PhD 《Suicide & life-threatening behavior》2013,43(3):250-261

Primary care providers were surveyed to determine how prepared they feel to address nonsuicidal self‐injury (NSSI) among adolescents, their interest in training on NSSI, and factors associated with routinely asking about NSSI when providing health supervision. Participants included family medicine physicians (n = 260), pediatricians (n = 127), family nurse practitioners (n = 96), and pediatric nurse practitioners (n = 54). Almost 50% felt unprepared to address NSSI, and over 70% wanted training in this area. Overall, relative to other areas of mental health care, clinicians felt least prepared to address and wanted more training on NSSI. Just 27% reported they routinely inquired about NSSI during health supervision. Factors associated with routinely asking about NSSI were identifying as female (OR = 2.37; 95% CI = 1.25–4.49), feeling better prepared to address NSSI (OR = 1.51; 95% CI = 1.04–2.20), and more frequently using a psychosocial interview to identify adolescents in distress (OR = 1.23; 95% CI = 1.02–1.48). Teaching clinicians to assess NSSI within a psychosocial interview may increase screening for and identification of the behavior among adolescents in primary care.  相似文献   

    

Kristy K. Ward MD  Angelica M. Roncancio PhD  Steven C. Plaxe MD 《Suicide & life-threatening behavior》2013,43(1):109-115

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Paul N. Pfeiffer MD  Hyungjin M. Kim ScD  Dara Ganoczy MPH  Kara Zivin PhD  Marcia Valenstein MD 《Suicide & life-threatening behavior》2013,43(4):356-365

We evaluated whether treatment‐resistant depression (TRD) as measured by the Massachusetts General Hospital (MGH) staging method was associated with suicide in a large U.S. health system. Data from the Veterans Health Administration and the National Death Index were used to conduct a case–control study of patients newly diagnosed with depression who received antidepressant treatment between 2003 and 2006. Suicide cases (N = 499) were matched with nonsuicide controls (N = 1994). Conditional logistic regression was used to assess whether MGH stage at time of suicide (or matched date) was associated with case status, adjusting for patient demographic characteristics, comorbidity, and service use. Results indicated 11.6% of suicide cases had MGH stage 3 or greater (indicating at least two antidepressant trials) compared to 6.4% of controls (p < .001). In adjusted analyses, suicide was not significantly more likely among patients with stage 3 or greater (OR 1.52; 95% CI: 0.98, 2.37) or stages 1.5–2.5 (OR 1.19; 95% CI: 0.91, 1.55) compared to patients with stage 1 or less (<10 weeks of antidepressant medication). Staging TRD using MGH criteria is unlikely to substantially improve suicide risk assessment of depressed patients beyond existing measures contained in health system records.  相似文献   

    

Sverre Varvin MD  Dr Philos 《The International journal of psycho-analysis》2013,94(3):431-435

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