Predictors of Suicidal Ideation in a Gender‐Stratified Sample of OEF/OIF Veterans

There is a growing concern about suicide among Operation Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF) veterans. We examined the role of postdeployment mental health in associations between deployment stressors and postdeployment suicidal ideation (SI) in a national sample of 2,321 female and male OEF/OIF veterans. Data were obtained via survey, and path analysis was used. For women and men, mental health symptoms largely accounted for associations between deployment stressors and SI; however, they only partly accounted for the sexual harassment and SI association among women. These findings enhance the understanding of the mental health profile of OEF/OIF veterans.     

Awareness Effects of a Youth Suicide Prevention Media Campaign in Louisiana

Research on the efficacy of mediated suicide awareness campaigns is limited. The impacts of a state‐wide media campaign on call volumes to a national hotline were analyzed to determine if the advertisements have raised awareness of the hotline. We use a quasi‐experimental design to compare call volumes from ZIP codes where and when the campaign is active with those where and when the campaign is not active. Multilevel model estimates suggest that the campaign appears to have significantly and substantially increased calls to the hotline. Results from this study add evidence to the growing public health literature that suggests that mediated campaigns can be an effective tool for raising audience awareness.     

Suicide Attempt Risk in Youths: Utility of the Harkavy–Asnis Suicide Scale for Monitoring Risk Levels

The Harkavy–Asnis Suicide Scale (HASS), one of the few self‐report scales assessing suicidal behavior was evaluated and ideation, was evaluated and predictors of suicide attempts (SAs) were identified with the goal of developing a model that clinicians can use for monitoring SA risk. Participants were 131 pediatric emergency department (ED) patients with suicidal behavior. The HASS and Diagnostic Interview Schedule for Children (DISC‐IV) were administered approximately 2 months after ED presentation. When compared with DISC‐IV ratings, sensitivity of the HASS SA items was excellent (100%), and overall classification accuracy was 72%. SA planning was the strongest predictor of SAs.     

The Impact of Exercise on Suicide Risk: Examining Pathways through Depression,PTSD, and Sleep in an Inpatient Sample of Veterans

Suicide has a large public health impact. Although effective interventions exist, the many people at risk for suicide cannot access these interventions. Exercise interventions hold promise in terms of reducing suicide because of their ease of implementation. While exercise reduces depression, and reductions in depressive symptoms are linked to reduced suicidal ideation, no studies have directly linked exercise and suicide risk. The current study examined this association, including potential mediators (i.e., sleep disturbance, posttraumatic stress symptoms, and depression), in a sample of Veterans. SEM analyses revealed that exercise was directly and indirectly associated with suicide risk. Additionally, exercise was associated with fewer depressive symptoms and better sleep patterns, each of which was, in turn, related to lower suicide risk.     

Suicide Attempts and Suicide among Marines: A Decade of Follow‐up

Suicidal behavior among military personnel is of paramount public health importance because of the increased risk of death from suicide in this population. Pre‐ and post‐Marine recruit training risk factors for suicide attempts among current and former Marines were examined in 10 years following recruit training. The characteristics of the subsample of current and former Marines who died by suicide during this time are also described. Stressful and traumatic life events (e.g., childhood physical, sexual, and emotional abuse, sexual harassment during recruit training) and pre‐recruit training suicide attempts emerged as having strong associations with post‐recruit training attempts. Half of those who died by suicide in the 10 years following recruit training endorsed at least one significant life stressor prior to joining the Marines. This study highlights the importance of screening for stressful and potentially traumatic experiences occurring both before and during military service as part of a comprehensive suicide risk assessment in military samples.     

Age‐Specific Characteristics of Serious Suicide Attempters in China

Characteristics of four age groups of patients with medically serious suicide attempts from nine general hospitals in China (N = 617) were compared. There were no significant age‐group differences by residence (rural vs. urban), method of attempt, proportion with prior attempts, or level of family functioning. Attempters <20 years of age were less likely to use alcohol at the time of the attempt. Attempters age 20–44 years had less regular contact with family members but were more likely to make the attempt in the presence of someone else. And attempters ≥ 45 years were more likely to have high suicidal intent, lower quality of life, mood disorders, and substance abuse disorders. These results highlight the need for age‐specific intervention programs for suicide attempters.     

The Effect of Cancer on Suicide among Elderly Holocaust Survivors

Jewish‐Israelis of European origin with cancer have higher suicide rates relative to their counterparts in the general population. We investigated whether this effect results from the high proportion of Holocaust survivors among them, due to vulnerabilities arising from the earlier traumas they sustained. The study was based on all Jewish‐European persons with cancer, 60 years and over, diagnosed in Israel between 1999 and 2007. The standardized incidence ratios were not significantly different between the exposed and nonexposed groups (men: 0.90, 95% CI 0.60–1.19; women: 0.95, 95% CI 0.55–1.37). Past exposure to maximum adversity did not increase the suicide risk among persons with cancer.     

Religion and Suicide in Patients with Mental Illness or Cancer

In Switzerland, the highest rates of suicide are observed in persons without religious affiliation and the lowest in Catholics, with Protestants in an intermediate position. We examined whether this association was modified by concomitant psychiatric diagnoses or malignancies, based on 6,909 suicides (ICD‐10 codes X60‐X84) recorded in 3.69 million adult residents 2001–2008. Suicides were related to mental illness or cancer if codes F or C, respectively, were mentioned on the death certificate. The protective effect of religion was substantially stronger if a diagnosis of cancer was mentioned on the death certificate and weaker if a mental illness was mentioned.     

Suicide Attempts within 12 Months of Treatment for Substance Use Disorders

There are limited prospective data on suicide attempts (SA) during the months following treatment for substance use disorders (SUD), a period of high risk. In an analysis of the Drug Abuse Treatment Outcomes Study, a longitudinal naturalistic multisite study of treated SUDs, variables associated with SA in the 12 months following SUD treatment were examined. Participants included 2,966 patients with one or more SUDs. By 12 months, 77 (2.6%) subjects had attempted suicide. Multivariate logistic regression analyses were used to identify variables associated with SA. Variables collected at baseline that were associated with SA included lifetime histories of SA, suicidal ideation (SI), depression, cocaine as primary substance of use, outpatient methadone treatment, and short‐term inpatient treatment. Male sex, older age, and minority race or ethnicity were associated with lower likelihood of SA. After controlling for baseline predictors, variables assessed at 12 months associated with SA included SI during follow‐up and daily or more use of cocaine. The data contribute to a small but growing literature of prospective studies of SA among treated SUDs, and suggest that SUDs with cocaine use disorders in particular should be a focus of prevention efforts.     

Suicide Risk Protocols: Addressing the Needs of High Risk Youths Identified through Suicide Prevention Efforts and in Clinical Settings

Several agencies have emphasized the importance of establishing clear protocols or procedures to address the needs of youths who are identified as suicidal through suicide prevention programs or in emergency department settings. What constitutes optimal guidelines for developing and implementing such protocols, however, is unclear. At the request of the Substance Abuse and Mental Health Services Administration, we provide an overview of recommendations, as well as steps taken in conjunction with selected prevention programs and in emergency department settings to address the needs and improve the care of these youths.