Six‐Month Trajectory of Suicidal Ideation in Adolescents with Borderline Personality Disorder

Few studies have longitudinally examined suicidal ideation in those with adolescent‐onset borderline personality disorder (BPD). The current study aimed to examine the trajectory of suicidal ideation in adolescents with BPD longitudinally over 6 months, with follow‐ups at 2, 4, and 6 months posthospitalization for elevated suicide risk. Results indicated that the BPD group exhibited a greater decrease in suicidal ideation in the months following hospitalization than those without a BPD diagnosis. The findings of this study indicated that suicidal ideation in adolescents with BPD is not stable, and although ideation may decrease quickly after hospitalization, regular assessment of ideation is recommended.     

Risk‐Related and Protective Correlates of Nonsuicidal Self‐Injury and Co‐Occurring Suicide Attempts among Incarcerated Women

Individual and environmental correlates of nonsuicidal self‐injury (NSSI) and co‐occurring suicide attempts (SA) among incarcerated women (N = 104) were examined. Participants completed measures of putative risk and protective factors, including coping styles, childhood maltreatment, and hopelessness. Results indicated that active coping was uniquely, negatively associated with the presence and frequency of NSSI, whereas avoidant coping and childhood physical/emotional abuse were positively associated with NSSI frequency. Conversely, among women with a history of NSSI, hopelessness was uniquely, positively associated with the presence and frequency of SA. Further, childhood sexual abuse was associated with the presence of SA, while physical/emotional abuse was associated with SA frequency. Hopelessness was more strongly related to SA frequency than NSSI frequency. These findings help disentangle the unique risk and protective factors for NSSI and co‐occurring SA in incarcerated samples.     

Self‐Efficacy to Avoid Suicidal Action: Factor Structure and Convergent Validity among Adults in Substance Use Disorder Treatment

Individuals with substance use disorders (SUDs) are at high risk of suicidal behaviors, highlighting the need for an improved understanding of potentially influential factors. One such domain is self‐efficacy to manage suicidal thoughts and impulses. Psychometric data about the Self‐Efficacy to Avoid Suicidal Action (SEASA) Scale within a sample of adults seeking SUD treatment (N = 464) is provided. Exploratory factor analysis supported a single self‐efficacy construct. Lower SEASA scores, or lower self‐efficacy, were reported in those with more severe suicidal ideation and those with more suicide attempts, providing evidence for convergent validity. Implications of measuring self‐efficacy in the context of suicide risk assessment are discussed.     

Support Groups for Suicide Survivors: Results of a Survey of Group Leaders

To update and expand Rubey and McIntosh's (1996) survivors of suicide support groups report, SPAN USA completed a survey of U.S. support group leaders (n = 100; 24% completion). There are now more survivor groups (from 280 to 417), and the majority of groups now have a survivor leader (78% vs. 25%). Groups continue to be small (88% < 10 members per session) and meet on a monthly basis (55%). Sharing continues to be a universal experience in groups, which tend to be open‐ended (85%). Current groups are newer, and more operate without a sponsor. Further research is needed to examine group member perspectives and effectiveness of groups.     

Definitions of Suicide and Self‐Harm Behavior in an Australian Aboriginal Community

In this small qualitative grounded theory study (21 interviews and focus groups with a total of 26 participants) investigating the understandings of and attitudes toward suicide and self‐harm of Aboriginal peoples in a coastal region of New South Wales, Australia, we found that cultural factors particular to these communities influence the way such behavior is defined in an Aboriginal context. A continuation of certain “traditional” cultural forms of self‐harm behavior was evident in participant definitions, notably the practice of female hair cutting, also described as a mourning ritual, which appears to serve as a marker both to the individual and others.     

Caregiver Strain and Youth Suicide Attempt: Are They Related?

There are scant data documenting the relationship between caregiver strain and suicidal behavior among youth. This study includes data from the caregivers of 1,854 youth who received services through the Comprehensive Community Mental Health Services for Children and Their Families Program. Caregiver strain, family functioning, and youth functional impairment were assessed with the Caregiver Strain Questionnaire, Family Life Questionnaire, and Columbia Impairment Scale. Caregivers of suicidal and nonsuicidal youth differed in subjective internalizing strain (e.g., worry and guilt) and objective strain (e.g., constraints on activities). Differences in objective strain persisted even after controlling for family life and youth functional impairment.     

An Inquiry into Relationship Suicides and Reciprocity

Few theories on suicide have been grounded in the norm of reciprocity. There is literature on suicide, however, describing motivations such as retaliation and retreat which can be interpreted as modes of adaptation to the norm of reciprocity. We propose a reciprocity‐based theory to explain suicides associated with relationship problems. Employing a content analysis of suicide notes, we tested the theory, finding evidence of exploitation, exploiter guilt, retaliation, and retreat as motives for committing relationship‐based suicide. Reciprocity‐based note writers were more likely to have used alcohol or drugs in the hours prior to committing suicide, and they were also more likely to have made their intentions known beforehand. Implications for future research as well as for suicide prevention are discussed.     

Beyond Randomized Controlled Trials in Attempted Suicide Research

There is a lack of evidence about what is the best treatment for people who present to hospital after self harm. Most treatment trials have been small and involved unrepresentative groups of patients which result in inconclusive findings. Here we note some of the characteristics of attempted suicide which make it a difficult subject to study. We describe the problems of doing randomized controlled trials in attempted suicide and outline the advantages and difficulties of randomized controlled trials, Zelen designs, patient preference designs, and cluster randomized trials in attempted suicide intervention trials. Researchers and consumers should consider other research designs when asking what is effective after self harm.