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   

    

Elizabeth A. Velkoff BA  Lauren N. Forrest BS  Dorian R. Dodd MA  April R. Smith PhD 《Suicide & life-threatening behavior》2016,46(3):313-322

Objective measures of suicide risk can convey life‐saving information to clinicians, but few such measures exist. This study examined an objective measure of fearlessness about death (FAD), testing whether FAD relates to self‐reported and physiological aversion to death. Females (n = 87) reported FAD and disgust sensitivity, and facial electromyography was used to measure physiological facial responses consistent with disgust while viewing death‐related images. FAD predicted attenuated expression of physiological death aversion, even when controlling for self‐reported death‐related disgust sensitivity. Diminished physiological aversion to death‐related stimuli holds promise as an objective measure of FAD and suicide risk.  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   

    

Augustine Kposowa PhD  David Hamilton MA  Katy Wang BA 《Suicide & life-threatening behavior》2016,46(6):678-696

Past studies on suicide have investigated the association of firearm ownership and suicide risk in the United States. The aim of the present study was to build on previous work by examining the impact of firearm storage practices and the strictness of firearm regulation on suicide rates at the state level. Data were compiled from primarily three sources. Suicide and firearm ownership information was obtained from the Centers for Disease Control and Prevention. Strictness of handgun regulation was derived from figures available at the Law Center to Prevent Violence, and controls were taken from the US Bureau of the Census. Mixed models were fitted to the data. Household firearm ownership was strongly associated with both suicide by all mechanisms, and firearm suicide. Storage practices had especially elevated consequences on suicide rates. Percent with loaded guns and gun readiness increased suicide rates, and strictness of gun regulation reduced suicide rates. Ready access to firearms can make a difference between life and death. Loaded and unlocked firearms within reach become risk factors for fatal outcomes from suicidal behavior. Future research might want to examine ways of obtaining more recent data on individual firearm ownership. This study proposes several policy recommendations for suicide prevention.  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   

    

Colleen Jacobson PhD  Kristen Batejan MA  Marjorie Kleinman MS  Madelyn Gould PhD  MPH 《Suicide & life-threatening behavior》2013,43(6):646-662

The motives of suicide attempts among a community sample of 99 U.S. high school students were explored. Participants completed an in‐depth computer‐assisted self interview about their most recent attempts as well as additional psychosocial measures. Results indicated that nearly 75% of the adolescents engaged in suicide attempts for reasons other than killing themselves and that depressive symptoms and premeditation prior to the attempt were significantly associated with increased risk for engaging in the attempts with death as a clear motive. Linking motive for an attempt (death, interpersonal communication, emotion regulation) and treatment approach may improve prevention of subsequent attempts and completed suicides.  相似文献   

    

Madelyn S. Gould PhD  MPH  Wendi Cross PhD  Anthony R. Pisani PhD  Jimmie Lou Munfakh BA  Marjorie Kleinman MS 《Suicide & life-threatening behavior》2013,43(6):676-691

We examined the impact of the implementation of Applied Suicide Intervention Skills Training (ASIST) across the National Suicide Prevention Lifeline's national network of crisis hotlines. Data were derived from 1,507 monitored calls from 1,410 suicidal individuals to 17 Lifeline centers in 2008–2009. Callers were significantly more likely to feel less depressed, less suicidal, less overwhelmed, and more hopeful by the end of calls handled by ASIST‐trained counselors. Few significant changes in ASIST‐trained counselors' interventions emerged; however, improvements in callers' outcomes were linked to ASIST‐related counselor interventions, including exploring reasons for living and informal support contacts. ASIST training did not yield more comprehensive suicide risk assessments.  相似文献   

    

Alison M. Lake MA  Suganthi Kandasamy MPH  Marjorie Kleinman MS  Madelyn S. Gould PhD  MPH 《Suicide & life-threatening behavior》2013,43(6):692-703

We examined teenagers' attitudes about the role of mental illness in suicidal behavior and the relationship between these attitudes and suicide risk. Serious suicidal ideation or behavior and associated risk factors (gender, depression, substance problems, and first‐hand experience with a suicidal peer) were assessed in 2,419 students at six New York high schools. Less than one fifth of students thought that mental illness was a major contributor to suicide. Suicidal adolescents and those at risk were less likely than their nonsuicidal and low‐risk counterparts to associate suicide with mental illness. Our findings contribute to the debate over whether accepting attitudes toward suicide increase suicide risk.  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