The Association of Multiple Identities with Self‐Directed Violence and Depression among Transgender Individuals

Transgender individuals have a high prevalence of self‐directed violence; however, there is scant literature focusing on their unique experiences. The differences in self‐harm, suicidal ideation, suicide attempt, and depression based on racial/ethnic identity and sexual orientation were examined among transgender individuals. Data were gathered from the Fall 2008 and Spring 2009 National College Health Assessment. Across racial/ethnic identities, greater proportions of transgender students endorsed self‐directed violence than their cisgender peers. Among transgender individuals, sexual minorities were more likely to report suicidal ideation than their heterosexual peers, and racial/ethnic minorities had higher odds of attempting suicide than non‐Hispanic White individuals.     

Correlates of Suicidal Ideation in Physically Injured Trauma Survivors

Epidemiologic studies have documented that injury survivors are at increased risk for suicide. We evaluated 206 trauma survivors to examine demographic, clinical, and injury characteristics associated with suicidal ideation during hospitalization and across 1 year. Results indicate that mental health functioning, depression symptoms, and history of mental health services were associated with suicidal ideation in the hospital; being a parent was a protective factor. Pre‐injury posttraumatic stress disorder symptoms, assaultive injury mechanism, injury‐related legal proceedings, and physical pain were significantly associated with suicidal ideation across 1 year. Readily identifiable risk factors early after traumatic injury may inform hospital‐based screening and intervention procedures.     

Culture,Gender, and Suicidal Behavior in Sri Lanka

In less than 50 years, the rate of suicide among Sri Lankans has risen from a modest level to one of the highest in the world. This article describes the current pattern of suicides, including sex differences and similarities, and reviews some of the institutional practices, material conditions, and social norms that may figure in the increases. A study is reported, which asked how ordinary Sri Lankans account for suicidal behavior and what practices they recommend for assisting suicidal individuals. Gender inflected these accounts, with essentialist accounts associated with women's suicides and contextual accounts associated with men's suicides.     

Childhood Parental Death and Lifetime Suicide Attempt of the Opposite‐Gender Offspring in a Nationwide Community Sample of Korea

Although previous studies have shown that childhood parental death influences suicide attempts of their offspring, few studies have examined influence of gender and age at exposure. Koreans show the third highest suicide rate in the world, and many children and adolescents lost their parents during and after the Korean War. A total of 12,532 adults, randomly selected through a one‐person‐per‐household method, completed the Korean version of the Composite International Diagnostic Interview and questionnaire for suicidal ideation, plan, and attempt (response rate 80.2%). A total of 2,332 subjects experienced biological parental death in childhood (18.6%). Male suicide attempts were associated with age of exposure to maternal death from 0 to 4 years (adjusted OR = 4.48, 95% CI 1.32–15.18) and from 5 to 9 years (adjusted OR = 5.52, 95% CI 1.97–16.46), but not with paternal death, after adjusting for age, education years, marital status, monthly income, and psychiatric comorbidities. Female suicide attempts were associated with paternal death from 5 to 9 years (adjusted OR = 2.20, 95% CI 1.13–4.27), but not with maternal death. Childhood parental death is significantly associated with lifetime suicide attempt in the opposite‐gender offspring, especially when exposure occurs before age 10.     

Treating the Capability for Suicide: A Vital and Understudied Frontier in Suicide Prevention

Current efforts at suicide prevention center largely on reducing suicidal desire among individuals hospitalized for suicidality or being treated for related psychopathology. Such efforts have yielded evidence‐based treatments, and yet the national suicide rate has continued to climb. We propose that this disconnect is heavily influenced by an unmet need to consider population‐level interventions aimed at reducing the capability for suicide. Drawing on lessons learned from other public health phenomena that have seen drastic declines in frequency in recent decades (HIV, lung cancer, motor vehicle accidents), we propose that current suicidality treatment efforts trail current suicidality theories in their lack of focus on the extent to which individuals thinking about suicide are capable of transitioning from ideation to attempt. We summarize extant evidence for specific capability‐centered approaches (e.g., means safety) and propose other options for improving our ability to address this largely overlooked variable. We also note that population‐level approaches in this regard would represent an important opportunity to decrease risk in individuals who either lack access to evidence‐based care or underreport suicidal ideation, as a reduced capability for suicide would theoretically diminish the potency of suicidal desire and, in this sense, lower the odds of a transition from ideation to attempt.     

The Interpersonal Theory of Suicide Applied to Male Prisoners

The interpersonal theory of suicide proposes that severe suicide ideation is caused by the combination of thwarted belongingness (TB) and perceived burdensomeness (PB), yet few studies have actually examined their interaction. Further, no studies have examined this proposal in male prisoners, a particularly at‐risk group. To address this gap, the current study surveyed 399 male prisoners. TB and PB interacted to predict suicide ideation while controlling for depression and hopelessness. High levels of both TB and PB were associated with more severe suicide ideation. The interpersonal theory may aid in the detection, prevention, and treatment of suicide risk in prisoners.     

Methods of Suicide Among Cancer Patients: A Nationwide Population‐Based Study

A 3‐year nationwide population‐based data set was used to explore methods of suicide (violent vs. nonviolent) and possible contributing factors among cancer patients in Taiwan. A total of 1,065 cancer inpatients who committed suicide were included as our study sample. The regression shows that those who had genitourinary cancer were 0.55 times (p = 0.047) less likely to use violent methods to commit suicide than those who had respiratory cancer. Among those who committed suicide out of town, the odds of using violent methods were 1.39 (p = 0.015) of their counterparts who had committed suicide in their hometowns. Those who had income between NT$15,841～NT$25,000 were 0.70 (p = 0.042) times less likely to use violent methods to commit suicide than those who had no income.     

A Systematic Review of Mass Media Campaigns for Suicide Prevention: Understanding Their Efficacy and the Mechanisms Needed for Successful Behavioral and Literacy Change

Mass media campaigns are increasingly seen as an important part of suicide prevention; however, despite their popularity, their efficacy is not well understood. The current review aimed to address key knowledge gaps regarding how mass media campaigns can be optimized to prevent suicide, by looking at their global efficacy, and mechanisms related to successful outcomes. A systematic review of the international literature examined studies which evaluated mass media campaigns targeted at suicide prevention, where suicide behaviors (mortality, attempts) or suicide literacy (knowledge, attitudes, help‐seeking) was identified as a primary outcome. Thirteen articles describing 12 unique campaigns met eligibility criteria. For behavioral outcomes, mass media campaigns appear to be most effective when delivered as part of a multicomponent suicide prevention strategy, while “standalone campaigns” were modestly useful for increasing suicide literacy. Level of exposure, repeat exposure, and community engagement appeared to be fundamental to the success of these campaigns; however, these constructs were poorly adhered to in the development and implementation of campaigns. Overall, the mixed quality of the included studies highlights a need for increased quantity, consistency, and quality of evaluations to advance the evidence base.     

Assessment of Suicidal Youth in the Emergency Department

Accurate evaluation of suicidal adolescents in the emergency department (ED) is critical for safety and linkage to follow‐up care. We examined self‐reports of 181 adolescents who presented to an ED with suicidal ideation (SI) or a suicide attempt (SA). Parents also completed self‐reports. Results showed fair agreement between parents and youth on the reason for the ED visit (e.g., SI vs. SA) and greater agreement between independent judges and youths than between judges and parents. In accordance with accepted definitions of suicide attempts (e.g., Crosby, Ortega, & Melanson, 2011; O'Carroll, Berman, Maris, Moscicki, Tanney, & Silverman, 1996, p. 237; Posner, Oquendo, Gould, Stanley, & Davies, 2007, p. 1035; Silverman, Berman, Sanddal, O'Carroll, & Joiner, 2007, p. 248), most youth with SA as the reason for the ED visit reported some intent to die associated with the attempt. Finally, youth presenting to the ED with SA did not differ clinically from youth presenting with SI, and almost half of youths with SI reported past suicide attempts. These results highlight the need to emphasize adolescents' reports in clinical decision making, suggest adolescents' defined suicide attempts similarly to published definitions, and show that assessment of past SAs, as well as present suicidal thoughts and behaviors, is critical in determining future risk.