Patterns of Presentation for Attempted Suicide: Analysis of a Cohort of Individuals Who Subsequently Died by Suicide

All suicides and related prior attempts occurring in Northern Ireland over two years were analyzed, focusing on number and timing of attempts, method, and mental health diagnoses. Cases were derived from coroner's records, with 90% subsequently linked to associated general practice records. Of those included, 45% recorded at least one prior attempt (with 59% switching from less to more lethal methods between attempt and suicide). Compared with those recording one attempt, those with 2+  attempts were more likely to have used less lethal methods at the suicide (OR = 2.77: 95% CI = 1.06, 7.23); and those using less lethal methods at the attempts were more likely to persist with these into the suicide (OR = 3.21: 0.79, 13.07). Finally, those with preexisting mental problems were more likely to use less lethal methods in the suicide: severe mental illness (OR = 7.88: 1.58, 39.43); common mental problems (OR = 3.68: 0.83, 16.30); and alcohol/drugs related (OR = 2.02: 0.41, 9.95). This analysis uses readily available data to highlight the persisting use of less lethal methods by visible and vulnerable attempters who eventually complete their suicide. Further analysis of such conditions could allow more effective prevention strategies to be developed.     

Temporal Fictionalism for a Timeless World

Current debate in the metaphysics of time ordinarily assumes that we should be realists about time. Recently, however, a number of physicists and philosophers of physics have proposed that time will play no role in a completed theory of quantum gravity. This paper defends fictionalism about temporal thought, on the supposition that our world is timeless. We argue that, in the face of timeless physical theories, realism about temporal thought is unsustainable: some kind of anti-realism must be adopted. We go on to provide an argument against eliminativism about temporal thought. While it doesn't follow from this argument that fictionalism about temporal thought is true, we suggest that this nonetheless shows that fictionalism should be regarded as the preferred view.     

Exploring Thematic Nightmare Content and Associated Self‐Harm Risk

Nightmares have been shown to be robust predictors of self‐harm risk, beyond depressive symptoms and hopelessness at times. However, few studies have investigated associations between nightmare content and increased self‐harm risk. This study explored associations of thematic nightmare content with history of self‐harm, and risk of self‐harm phenomena the morning following a nightmare. A mixed‐method diary study was performed. Prospective nightmare reports were obtained from 72 participants. A total of 47 nightmare reports met inclusion criteria and were analyzed for themes using inductive thematic analysis. Chi‐square and bootstrap Pearson's correlation tests were performed to assess the associations between nightmare themes and self‐harm history, and risk of self‐harm phenomena following a nightmare. “ Powerlessness to Change Behavior” was associated with a history of self‐harm engagement, whereas “Financial Hardship” indicated reduced risk. Themes were not significantly associated with increased risk of self‐harm phenomena following a nightmare. Content may be of use in detecting lifetime history of self‐harm engagement, particularly in populations where disclosure is seen as taboo. However, nightmare symptom severity remains a better indicator of risk. Evidence for the utility of nightmare content in assessing immediate self‐harm risk is presently lacking. Replication with increased power is recommended.