Suicide Attempts in Major Depressed Patients with Personality Disorder

Suicide attempters who met criteria for borderline personality disorder (BPD) comorbid with major depressive disorder (MDD) were compared to both suicide attempters suffering from MDD alone and to attempters with comorbid MDD and other personality disorders (PD). Participants were 239 (158 patients with comorbid PD and 81 patients with MDD without comorbidity) inpatients consecutively admitted after a suicide attempt made in the last 24 hours. Suicide attempters with comorbid MDD and BPD had more frequent previous suicide attempts and were more likely to have a history of aggressive behaviors and alcohol and drug use disorders compared with patients suffering from MDD without Axis II comorbidity.     

Increased Risk of Suicidal Ideation in Smokers and Former Smokers Compared to Never Smokers: Evidence from the Baltimore ECA Follow‐Up Study

The incidence rate of suicidal ideation among current and former smokers versus never smokers is not known. In this study, the age‐adjusted incidence of suicidal ideation was highest among current smokers, followed by former, then never smokers. The adjusted hazard for suicide ideation was 2.22 (95%CI = 1.48, 3.33) and 1.19 (95%CI = 0.78, 1.82) for current and former smokers, respectively, compared to never smokers. Results indicate that current smokers have increased risks of suicidal ideation above and beyond the risk for never and former smokers regardless of age, gender, history of depressive disorder or anxiety symptoms, and alcohol abuse/dependence. Smoking cessation might be beneficial for some suicide prevention efforts.     

Retracted: The Three-Step Theory of Suicide: An Independent Replication and Conceptual Extension

Retraction: Christopher R. Hagan PhD, Jennifer J. Muehlenkamp PhD, “The Three-Step Theory of Suicide: An Independent Replication and Conceptual Extension,” Suicide and Life-Threatening Behavior, Wiley, © American Association of Suicidology The above article, published online on 30 September 2019 in Wiley Online Library ( wileyonlinelibrary.com ), has been retracted by agreement between the authors, the journal Editor in Chief, Thomas Joiner, PhD, and John Wiley and Sons Ltd. The retraction has been agreed due to errors in variable calculation and a post-publication reviewer's concerns that some analyses did not accurately test the theoretical model. An updated version of this article will soon undergo review for publication at Suicide and Life-Threatening Behavior, and if accepted for publication, will be accompanied by an editorial from the Editor-in-Chief.     

Positive and Negative Expectations of Hopelessness as Longitudinal Predictors of Depression,Suicidal Ideation,and Suicidal Behavior in High‐Risk Adolescents

The relationship between hopelessness and depression in predicting suicide‐related outcomes varies based on the anticipation of positive versus negative events. In this prospective study of adolescents at elevated risk for suicide, we used two Beck Hopelessness Scale subscales to assess the impact of positive and negative expectations in predicting depression, suicidal ideation, and suicidal behavior over a 2‐ to 4‐year period. In multivariate regressions controlling for depression, suicidal ideation, and negative‐expectation hopelessness, positive‐expectation hopelessness was the only significant predictor of depressive symptoms and suicidal behavior. Clinical interventions may benefit from bolstering positive expectations and building optimism.     

Negative Intrusive Thoughts and dissociation as Risk Factors for Self‐Harm

Relationships between self‐harm and vulnerability factors were studied in a general population of 432 participants, of whom 30% reported some experience of self‐harm. This group scored higher on dissociation and childhood trauma, had lower self‐worth, and reported more negative intrusive thoughts. Among the non‐harming group, 10% scored similarly to the self‐harmers on the dissociation and self‐worth scales, and engaged in potentially maladaptive behaviors that are not defined as indicating clinical self‐harm, but experienced fewer negative intrusive thoughts. This group may be at risk of future self‐harm if they begin to experience negative intrusive thoughts. If negative intrusive thoughts are playing a causal role, then therapeutic approaches tackling them may help those who are currently self‐harming.     

Depressive Symptoms and Health‐Related Risk‐Taking in Adolescence

This study investigated the relation between symptoms and a variety of health‐related risk‐taking behaviors during adolescence. A survey of 20,745 adolescents from the National Longitudinal Study of Adolescent Health provided data for analysis. Adolescents who reported more depressive symptoms were found to wear seatbelts less often, wear bike‐helmets less often, and drive while drunk more frequently. Depressive symptoms did not correlate with reported condom use. The found relations were all mediated by reported levels of hopelessness. Reported levels of anhedonia and suicidality also mediated some of the found relations. Therefore, adolescents experiencing depressive symptoms, especially those reporting hopelessness, should be considered at jeopardy for a variety of health‐related risk‐taking behaviors.     

The Definition and Epidemiology of Clusters of Suicidal Behavior: A Systematic Review

Suicide clusters are a rare and underresearched phenomenon which attract wide media attention and result in heightened concern in the communities where they occur. We conducted a systematic literature review covering the definition and epidemiology of the time–space clustering of suicidal behavior. Of the 890 articles identified by electronic searching, 82 were selected for inclusion and the extracted data were analyzed by narrative synthesis. Less than a third of studies included a definition of a suicide cluster, and definitions varied considerably. Clusters occurred in various settings, including psychiatric hospitals, schools, prisons, indigenous communities, and among the general population. Most clusters involved young people. The proportion of all episodes that occurred in clusters varied considerably between studies and partly depended on study methodology (e.g., a larger proportion was found in studies of specific clusters compared with general population studies). Future studies should aim to combine the statistical analysis of time–space clustering with a case study of events, which examines potential links between individuals and the wider environmental context.     

A Study of the Use and Interpretation of Standardized Suicide Risk Assessment: Measures within a Psychiatrically Hospitalized Correctional Population

The reliability, validity, and utility of the Adult Suicidal Ideation Questionnaire (ASIQ), Beck Hopelessness Scale (BHS), Beck Scale for Suicide Ideation (BSS), and Reasons for Attempting Suicide Questionnaire (RASQ) with correctional mental health populations was evaluated. Evidence was found indicating good to excellent reliability for all measures. Each of the measures significantly differentiated multiple attempters from single attempters and nonattempters, providing evidence of convergent and divergent validity. Logistic regression and receiver operating characteristic analyses revealed strong associations between multiple attempts and the ASIQ, BSS, and RASQ, but not the BHS. Implications for suicide risk assessment processes in correctional settings are discussed.     

Insomnia Symptoms,Nightmares, and Suicide Risk: Duration of Sleep Disturbance Matters

Duration of insomnia symptoms or nightmares was investigated to see if it was related to suicide risk independent of current insomnia symptoms, nightmares, anxiety symptoms, depressive symptoms, and posttraumatic symptoms. The cross‐sectional study involved analyses of survey responses from undergraduate students who endorsed either insomnia symptoms (n = 660) or nightmares (n = 312). Both insomnia symptom and nightmare duration were significantly associated with suicide risk independent of current insomnia symptoms or nightmares, respectively. Relations were also significant after controlling for anxiety symptoms, depressive symptoms, and posttraumatic symptoms. Results suggest that duration of sleep disturbance is relevant when assessing suicide risk.