Emergency Department Youth Patients With Suicidal Ideation or Attempts: Predicting Suicide Attempts Through 18 Months of Follow‐Up

This prospective study of suicidal emergency department (ED) patients (ages 10–18) examined the timing, cumulative probability, and predictors of suicide attempts through 18 months of follow‐up. The cumulative probability of attempts was as follows: .15 at 6 months, .22 at 1 year, and .24 by 18 months. One attempt was fatal, yielding a death rate of .006. Significant predictors of suicide attempt risk included a suicide attempt at ED presentation (vs. suicidal ideation only), nonsuicidal self‐injurious behavior, and low levels of delinquent symptoms. Results underscore the importance of both prior suicide attempts and nonsuicidal self‐harm as risk indicators for future and potentially lethal suicide attempts.     

A Minority Stress Model for Suicidal Ideation in Gay Men

There is a dearth of research on mechanisms underlying higher rates of suicidal ideation among gay men compared to heterosexual men. The purpose of this study was to establish the link between social/psychological predictor variables and suicidal ideation by testing a hypothesized minority stress model. Structural equation modeling was used to assess the relationships posited in the model using data from a community sample of 167 gay men. Model fit was adequate and hypothesized relationships were partially supported. Also, depressive symptoms partially mediated the relationship between (less) outness predicting suicidal ideation. These findings imply that therapeutic approaches targeting the coming out process may be more effective than approaches targeting internalized homophobia when suicidal ideation is indicated in the clinical presentation of gay and bisexual men.     

Emotion Dysregulation and Affective Intensity Mediate the Relationship Between Childhood Abuse and Suicide‐Related Behaviors Among Women with Bulimia Nervosa

Self‐harm and suicide attempts occur at elevated rates among individuals with bulimia nervosa, particularly among those who have experienced childhood abuse. This study investigated the potential mediating roles of emotion dysregulation and affective intensity in the relationship between these variables in 125 women with bulimia nervosa. Analyses revealed that emotion dysregulation mediated the relationship between sexual and emotional abuse with both self‐harm and suicide attempts. Negative affective intensity mediated the relationship between abuse and suicide attempts. The findings may advance the understanding of mechanisms underlying suicide‐related behaviors in women with bulimia nervosa who experienced abuse and suggest potential clinical targets.     

Examining Intent to Die and Methods for Nonsuicidal Self‐Injury and Suicide Attempts

Nonsuicidal self‐injury (NSSI) is linked to suicidal behavior and future suicide attempts, but the process of NSSI‐to‐suicide attempts remains unclear. Additionally, little is known about how having a history of NSSI may relate to reports of intent to die during a suicide attempt. The current study examined methods of NSSI and suicide attempts, as well as intent to die, in a sample of 1,232 young adults, 54 of whom reported at least one suicide attempt. Cutting and overdose were the predominant methods of NSSI and suicide attempts, respectively, with the two often co‐occurring. Individuals with both NSSI and suicide attempt history were significantly more likely to report an intent to die than those with suicide attempt history only.     

Impact of Applied Suicide Intervention Skills Training on the National Suicide Prevention Lifeline

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.     

Mental Disorders,Comorbidity, and Pre‐enlistment Suicidal Behavior Among New Soldiers in the U.S. Army: Results from the Army Study to Assess Risk and Resilience in Servicemembers (Army STARRS)

We examined the associations between mental disorders and suicidal behavior (ideation, plans, and attempts) among new soldiers using data from the New Soldier Study (NSS) component of the Army Study to Assess Risk and Resilience in Servicemembers (Army STARRS; N = 38,507). Most new soldiers with a pre‐enlistment history of suicide attempt reported a prior mental disorder (59.0%). Each disorder examined was associated with increased odds of suicidal behavior (ORs = 2.6–8.6). Only PTSD and disorders characterized by irritability and impulsive/aggressive behavior (i.e., bipolar disorder, conduct disorder, oppositional defiant disorder, and attention‐deficit/hyperactivity disorder) predicted unplanned attempts among ideators. Mental disorders are important predictors of pre‐enlistment suicidal behavior among new soldiers and should figure prominently in suicide screening and prevention efforts.     

Adolescents' Attitudes About the Role of Mental Illness in Suicide,and Their Association with Suicide Risk

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.     

Self‐Harm and Conventional Gender Roles in Women

A total of thirty‐two women admitted to a general hospital for medical treatment after self‐harming completed measures of conventional positive and negative masculinity and femininity. Comparisons were made with two control groups with no self‐harm history; 33 women receiving psychiatric outpatient treatment and a nonclinical sample of 206 women. Multinomial logistic regression analyses showed that those with lower scores on Instrumentality and Unmitigated Agency (positive and negative masculinity) and higher scores on Insecurity (negative femininity) had greater odds of self‐harming. Relationships were weaker after accounting for generalized self‐efficacy. Results are discussed in relation to previous findings and suggestions for prevention are made.     

Reasons for Attempting Suicide among a Community Sample of Adolescents

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.