Comparison of Suicide Attempters and Decedents in the U.S. Army: A Latent Class Analysis

A clearer understanding of risk factors for suicidal behavior among soldiers is of principal importance to military suicide prevention. It is unclear whether soldiers who attempt suicide and those who die by suicide have different patterns of risk factors. As such, preventive efforts aimed toward reducing suicide attempts and suicides, respectively, may require different strategies. We conducted a latent class analysis (LCA) to examine classes of risk factors among suicide attempters (n = 1,433) and decedents (n = 424). Both groups were represented by three classes: (1) External/Antisocial Risk Factors, (2) Mental Health Risk Factors, and (3) No Pattern. These findings support the conceptualization that military suicide attempters and decedents represent a single population.     

Teaching Towards the Post-human: The Courage to Entangle

Studies in Philosophy and Education -     

Fulfilment of intention and desire in children's judgements of emotion for sociomoral events

This study investigated whether children appreciate that enacting an intention can emotionally affect an agent separately from whether the agent's desire is fulfilled. Children ages 5–11 years and adults heard several vignettes about an agent who intended to take another child's toy in which the agent's intention was either enacted or blocked and desire was fulfilled or unfulfilled. The effect of intention on judgements of the agent's emotion varied according to desire fulfilment and age. Overall, participants judged that an agent who acted intentionally to fulfil a desire felt happier than an agent whose intention was blocked. When the agent's desire was unfulfilled, the effect of enacting an intention varied by age. Five‐ to 6‐year‐olds judged that acting intentionally could decrease the negative emotion associated with an unfulfilled desire. The findings show relatively early appreciation of intentionality in children's judgements of emotion. Happy victimizer attributions decreased between 5 and 8 years, but attributions of positive emotion to transgressors did not vary by intentionality. The relationships between intentionality, agency, and emotion are discussed.     

Vaginal bleeding and spotting in transgender men after initiation of testosterone therapy: A prospective cohort study (ENIGI)

Abstract

Background: Previous studies have cross-sectionally described amenorrhea in cohorts of transgender men on intramuscular or subcutaneous testosterone injections. It remains uncertain which testosterone preparations most effectively suppress vaginal bleeding and when amenorrhea occurs after testosterone initiation.

Aim:To investigate the clinical effects of various testosterone preparations on vaginal bleeding and spotting in transgender men.

Methods: This prospective cohort study was part of the European Network for the Investigation of Gender Incongruence (ENIGI). Data on the persistence and intensity of vaginal bleeding and spotting, serum sex steroid levels and body composition were prospectively and cross-sectionally assessed in 267 transgender men during a three-year follow-up period, starting at the initiation of various testosterone preparations.

Results: After three months of testosterone, 17.9% of transgender men reported persistent vaginal bleeding and 26.8% reported spotting. The percentages reporting vaginal bleeding and spotting decreased over the first year of testosterone (bleeding 4.7% and spotting 6.9% at 12?months, respectively), with no participants reporting vaginal bleeding or spotting after 18?months of testosterone. Factors associated with vaginal bleeding or spotting included lower serum testosterone levels and being on testosterone gel as compared to injections (e.g., esters or undecanoate preparations). If vaginal bleeding persisted, starting progestogens at three months resulted in a decrease in the intensity of vaginal bleeding and spotting.

Discussion: Transgender men and hormone-prescribing providers can be reassured that vaginal bleeding and spotting usually stop within three months after testosterone initiation. If not, serum testosterone levels should be measured and testosterone dose adjusted to achieve serum testosterone levels in the physiologic male range. Adding a progestin can be considered after three to six months if bleeding persists. Providers should be aware that cessation of bleeding can be more difficult to achieve in transgender men with lower serum testosterone levels or those on testosterone gel.     

Veteran Participation in Intensive Suicide Research Protocols: No Evidence of Iatrogenic Effects

Suicide research remains fraught with ethical and methodological issues, including researchers’ reservations about conducting intensive suicide research protocols due to potential iatrogenic effects and liability concerns. Such issues significantly impede scientific inquiry related to suicide. To date, no research has explored potential iatrogenic effects of intensive, nontreatment suicide research among Veterans. This study aimed to fill this gap. It was hypothesized that participation in suicide‐specific protocols would not significantly increase risk among Veterans. Veterans completed self‐reports, structured interviews, and rigorous suicide‐specific tasks (Study A, N = 34; Study B, N = 18; Study C, N = 119). Findings indicated there were no significant differences in pre‐ and postassessment suicide risk variables (all ps > .05). Estimated mean change for “urge to harm self” was ?0.24 (95% confidence interval [CI]: ?0.60, 0.13), ?0.28 (CI: ?0.56, 0.01), and ?0.01 (CI: ?0.09, 0.07) and “intent to harm self” was ?0.18 (95% CI: ?0.45, 0.10), 0 (CI: ?0.17, 0.17), and 0.01 (CI: ?0.04, 0.06) for Studies A, B, and C, respectively. Results indicated the respective protocols did not produce iatrogenic effects. The current findings are discussed with attention to safety‐monitoring techniques that may reduce iatrogenic effects and considerations for future researchers.