Life stress and suicidal ideation in Australian men – cross-sectional analysis of the Australian longitudinal study on male health baseline data

Background

Suicide is a leading cause of death in Australian males aged 18 to 55. Non-fatal suicidal behaviours and thoughts are indicators of increased risk for future suicide. Suicidal behaviour is complex and multi-determined. Research supports the involvement of stressful life events in suicide and suicidal behaviour, however the evidence regarding suicidal thoughts is less developed. This study investigates stressful life events in relation to suicidal ideation in a large cohort of adult males recruited into Ten to Men, the Australian Longitudinal Study on Male Health.

Methods

Baseline data from a national cohort of 13, 884 males aged 18–55 years on suicidal behaviour, psychiatric disorder and life events was used. Multivariable logistic regressions were conducted with current suicidal ideation as the outcome and 12 month life events, 12 month depression, anxiety and harmful/hazardous alcohol use, and socio-demographics as covariates. Further logistic regression models investigated the relative risk of life stress alone, depression/alcohol/anxiety alone and co-occurring life stress and depression/alcohol/anxiety.

Results

In multivariable models there was an independent contribution to suicidal ideation for six of 24 life events (ORs 1.27–1.95), 12 month depression (OR 4.49) harmful alcohol use (OR 1.38) and anxiety disorders (OR 1.27). Life events co-occurring with depression (OR 10.3) was higher risk than either alone (depression OR 6.6; life stress OR 2.6). There was a lesser effect for co-occurrence in the anxiety and harmful alcohol use models.

Conclusion

Life events appear to be related to suicidal ideation independent of depression, anxiety and harmful alcohol use in adult males, however if life events occur in the context of depression that risk is substantially increased.

     

Suicide: a concept analysis

Background

Suicide is a national and global phenomenon with its rate increasing every year inspite of clinicians, policy makers and researchers grappling with suicide prevention and investing heavily in risk assessment, prevention and reduction. There seems to be a gap in the understanding of suicide and its associated behaviours.

Aim

The aim of this review was to undertake a concept analysis of suicide and behaviour.

Method

The Walker and Avant eight-step method was adopted. Search engines including Academic Search Elite, CINAHL, Ovid Online embracing Embase and Ovid Medline were utilised to access articles published in the last 10 years, written in English, with abstracts and full text.

Results

The concept of suicide require understanding of implicity and explicity of suicidal intent and how these relate to suicide behaviour. Areas of risk assessment such as thwarted belongingness and perceived burdensomeness should be considered. Associated with suicide are internal and external hazards, which tend to create vulnerability leading to suicidal behaviour. Clinicians should differentiate between suicide in the presence of mental illness and when there is a predicament. Risk assessment tools should not be taken as absolute as they do not provide 100 % detection of intent.

Conclusion

Understanding the concept of suicide would help clinicians comprehend their patients and suicidal behaviour and improve intervention methods.

     

Suicide Prevention Among High School Students: Evaluation of a Nonrandomized Trial of a Multi-stage Suicide Screening Program

Background

Suicide is a leading cause of death among youth. Suicide screening programs aim to identify mental health issues and prevent death by suicide.

Objective

The present study evaluated outcomes of a multi-stage screening program implemented over 3 school years in a moderately-sized Midwestern high school.

Methods

One hundred ninety-three 9th-grade students were screened in the program. Students who screened positive were referred to mental health services and followed. Suicide-related thoughts and behaviors among 9th-grade students in the school with screening were compared to those of students in a similar school without screening.

Results

There was a significant increase in utilization of mental health services among students who screened positive and a decrease in rates of suicidal ideation and attempts among 9th-grade students at the school with screening.

Conclusions

This multi-stage screening program shows promise in addressing suicide-related behaviors in schools. Randomized trials are needed to confirm program efficacy.

     

Relationship of being threatened or injured with a weapon in school with suicidal ideation and attempt among school students: a school-based study in Zhejiang Province,China

Background

Suicide is the second leading cause of death among 15–29?year old youths globally, and the third most common external cause of death in China. School bullying can cause serious consequences among adolescents, including psychosocial problems, low self-esteem and post-traumatic stress disorder. Most studies examining the associations between being bullied in school and suicide are from Western, developed countries. Moreover, few studies focus on being threatened or injured with a weapon, which may cause serious body injury. Our study aimed to explore the relationship of being threatened or injured with a weapon in school with suicidal ideation and attempt among middle and high school students in Zhejiang Province, China.

Methods

A cross-sectional study of 23,543 students in grades 7–12 from 442 schools was carried out through an anonymous self-administered questionnaire between April and May 2017. Multivariable logistic regression models were used to examine the relationship of being threatened or injured with a weapon in school with suicidal ideation and attempt.

Results

51.3% of participants were boys, and mean (SD) age was 15.6 (1.7) years. The overall prevalence of suicidal ideation and attempt were 16.1% (95%CI: 15.3–16.9) and 3.6% (95%CI: 3.3–4.0), respectively. Prevalence was higher among girls than boys (ideation: 19.1% vs. 13.3%. attempt: 4.4% vs. 2.9%). 13.2% of students reported being threatened or injured with a weapon in school in the past 12?months (95%CI: 11.9–14.5), higher among boys than girls (15.7% vs. 10.5%), and among rural students than urban students (13.9% vs. 11.6%). After adjustment for socio-demographic status, lifestyle factors, academic performance, self-reported health and mental health, the odds ratios for suicidal ideation and attempt among students who reported being threatened or injured with a weapon were 1.46 (1.31–1.61) and 1.68 (1.31–2.13) respectively, as compared with those who did not report being threatened or injured.

Conclusions

Preventive measures for physical bullying in school need to be reinforced in China. Being threatened or injured with a weapon is associated with both suicidal ideation and attempt among middle and high school students. Suicide prevention should be an important component of psychological interventions for threatened or injured students.

     

Using Electronic Health Record Alerts to Increase Safety Planning with Youth At-Risk for Suicide: A Non-randomized Trial

Background

No study to date has examined the effectiveness of integrating clinical decision support tools, like electronic health record (EHR) alerts, into the clinical care of youth at-risk for suicide.

Objective

This study aimed to examine the feasibility and acceptability of using an EHR alert to increase clinicians’ use of safety planning with youth at-risk for suicide in an outpatient pediatric psychiatry clinic serving an urban low-income Latino community.

Methods

An alert intervention was developed to remind clinicians to complete a safety plan whenever they documented that their patient endorsed suicidal ideation, plan, or attempt during a visit in EHR notes. The alert appeared as a separate window containing a reminder message to complete a safety plan once a clinician finished visit documentation.

Results

There were 69 at-risk patients between the ages of 13–21 in the intervention period (M = 15.71; SD = 1.86; 66.7% female) and 64 (M = 15.38; SD = 1.93; 68.6% female) in the control period. Logistic regression analyses indicated that patients in the intervention period were significantly more likely than patients in the control period to receive a safety plan (p < .01). The pattern of results remained the same after adjusting for demographic variables (p = .01). Forty clinicians also completed a questionnaire assessing their satisfaction with the EHR alert, indicating moderate satisfaction (M = 3.01; SD = 0.63; range = 1.11–4.11).

Conclusions

EHR alerts are associated with changes in clinicians’ behavior and improved compliance with best clinical practices for at-risk youth.

     

Resilienzförderung

Background

Nearly every second person suffers from mental illness at some point in their life. In this regard, stress-induced illnesses play a central role. Stress cannot be avoided; thus, interventions that promote resilience in the face of stress are particularly significant.

Objective

The paper gives a short overview of the current status quo in the development of evidence-based resilience interventions.

Materials and methods

The chosen method is a narrative review that takes into account papers with relational resilience constructs such as concept analysis, systematic reviews, and empirical studies of international resilience research.

Results

Currently, the main challenge for program developers is to identify valid protective factors within resilience research which match the target and target group of a special intervention.

Conclusion

There is a need for systematic reviews to systematize heterogeneous resilience studies. Based on such reviews, the selection of protective factors that should be promoted in an intervention can be justified.

     

Rauchgewohnheiten von deutschen Medizinstudierenden in Deutschland und Ungarn

Background

Although many anti-tobacco measures have reduced the number of smokers in Germany, every fourth person still smokes and smoking is still an enormous burden for both the affected person and their relatives as well as for the healthcare system and society. Physicians have a key position in tobacco cessation, their health and smoking behavior is therefore of great importance.

Objective

To provide information about the distribution of tobacco consumption among medical students and to examine the influence of study site on tobacco consumption.

Material and methods

In a multicenter cross-sectional study, data on the health behavior of German medical students in two German and two Hungarian universities were collected in 2014 using a questionnaire.

Results

Of the 1384 students, 7.3% smoked daily, 9.1% occasionally and 11.9% were ex-smokers. The consumption of e?cigarettes was rare, whereas shisha smoking was more widespread among medical students. Among the study locations Munich had the lowest rates of occasional smoking for men and for women consuming shisha.

Conclusions

Medical students must be encouraged not to smoke. Our results highlight the need for smoking cessation programs at medical schools, including education about detrimental health effects of shisha use.

     

The benefits of sleep coaching in workplace health promotion

Aim

In the present study, the benefits of a short-term sleep coaching intervention embedded in the workplace health promotion (WHP) program of the German Armed Forces was investigated.

Participants and methods

Well-being, self-care awareness, self-care behavior and irritation of participants attending the sleep coaching (n = 24) and participants attending other courses offered in the WHP program (n = 24) were assessed before and after the intervention.

Results

Participants attending the sleep coaching had a significant increase in well-being, self-care behavior and self-care awareness and a significant decrease in their irritation score after attending the sleep coaching. In the control group, no significant change in the dependent variables was observed; furthermore, participants’ evaluation of the sleep coaching was positive on both affective reactions and utility judgements.

Conclusions

Results show that the sleep coaching intervention evaluated is practically feasible and able to improve important indicators of employees’ well-being and self-care in WHP programs.

     

Verhaltensstabilität und Gewohnheitsverhalten

Background

To develop a healthy habit, various authors suggest a 6? to 9?week period of continuous practice. Despite these findings, little is known about the impact of wellbeing and mood in this process.

Objectives

The purpose of this study is to investigate the behavioural requirements for habit formation regarding continuity and temporal consistency, and to understand the impact of wellbeing and mood during this process.

Methods

In all, 48 individuals had to choose an individual, health-oriented behaviour to carry out daily for 12 weeks. During the 12 weeks the participants completed the Self-Report Habit Index (SRHI), the Profile of Mood States (POMS) and a questionnaire gathering continuity, consistency and wellbeing each week.

Results

The findings show a significant increase in SRHI score over time, indicating that participants began to develop a habit, particularly in the initial weeks. Significant differences were found in continuity, consistency and regarding the mood state, but not with regard to comfort.

Conclusions

It has been proven that continuity and consistency play an important role in developing habits and that mood potentially influences this process.

     

Assessment of the psychometric properties of the Chinese Impact of Vision Impairment questionnaire in a population-based study: findings from the Singapore Chinese Eye Study

Purpose

We investigated whether the Chinese impact of vision impairment (IVI) questionnaire is valid to generate reliable person estimates in a population-based sample.

Methods

VRQoL was measured using the 32-item Chinese version of the IVI questionnaire in the Singapore Chinese Eye Study (2009–2011), a population-based study of the prevalence and risk factors for VI and eye diseases in Chinese Singaporeans. Rasch analysis was used to assess the Chinese IVI’s response category functioning, precision, unidimensionality, targeting and differential item functioning. The ability of the Chinese IVI to discriminate participants along the spectrum of VI demonstrated criterion validity.

Results

Of the 3353 participants, 27.2 % (n = 912) had VI (presenting visual acuity <6/12, better eye). Response categories were collapsed from six to four to resolve disordered thresholds. The Chinese IVI initially demonstrated multidimensionality and was split into three scales: ‘Reading and Accessing Information’; ‘Mobility and Independence’; and ‘Emotional Well-being’. All three scales were unidimensional and demonstrated excellent range-based precision (all reliability coefficients 0.97), following removal of three misfitting items. Mean person measures decreased with worsening VI (e.g. Reading: none (7.50 logits); mild (6.99 logits); moderate (6.44 logits); and severe (3.01 logits) VI; p < 0.001).

Conclusions

A three-dimensional 29-item Chinese IVI is a valid tool to assess the impact of VI on VRQoL in a large population-based sample, comprising over a quarter of participants with VI. The 28-item English IVI is also likely to be valid for use in population-based studies; however, this must be demonstrated empirically in future studies.

     

Association between mass media and body weight concern among Jordanian adolescents’ residents of Amman: the role of gender and obesity

Objectives

Body image in the mass media promotes an unrealistic picture of body shape that leads to body dissatisfaction among adolescentsQuery. Therefore, the study presented in this paper aimed to assess the association between mass media and adolescents’ weight concerns and perceptions of body weight and shape.

Methods

A cross-sectional survey was conducted on school adolescents aged between 15 and 18 years during the academic year 2013–2014. Multistage stratified sampling method was used. The number of participants in the study was 795 students: 400 boys and 395 girls.

Results

All participants have a common behavior in rarely reading magazines, but they spend more than 2 h in watching television or less than 3 h using the internet. However, most of obese/non-obese adolescents, boys or girls, have shown high influence (p < 0.05) of reading magazines on the subject of dieting to lose weight.

Conclusion

While obese students read more magazines on dieting to lose weight, other mass media did not show the same results on weight concerns and body shape among Jordanian adolescents.

     

Treatment Foster Care Pre-service Trainings: Changes in Parenting Attitudes and Fostering Readiness

Background

Pre-service training of treatment parents is a requirement for all foster care models to ensure safety and well-being of children in care. Researchers theorize treatment parents benefit more from enhanced pre-service trainings; however, no rigorous studies exist indicating the effectiveness of these trainings for treatment parents.

Objective

This quasi-experimental study aimed to determine if an enhanced pre-service training developed for treatment parents (n = 71) is more effective than a basic pre-service training (n = 81) in increasing their parenting attitudes, personal dedication and willingness to provide foster care, and licensing rates.

Methods

Secondary data analyses were performed on an archival dataset that included demographic information and training participant scores from three standardized measurements before and after pre-service trainings: Adult-Adolescent Parenting Inventory (AAPI-2), Personal Dedication to Fostering Scale, and Willingness to Foster Scale. Licensing status as a treatment parent at the end of the pre-service training was also available in the dataset.

Results

Pre/post analyses revealed enhanced pre-service training participants experienced significantly more change in two parenting constructs, and basic pre-service training participants experienced significantly more change in one parenting construct. There were no significant differences between groups in changes in personal dedication or willingness to provide foster care. Enhanced pre-service training participants were significantly more likely to become licensed as treatment parents than basic pre-service training participants.

Conclusions

The findings suggest an enhanced pre-service training may have potential impact on changing some parenting attitudes and an increased licensing status as a treatment parent.

     

„Der Depression Beine machen“

Background

The positive effects of physical activity and exercise on physical and psychological well-being are well documented. The project “To make a move on depression” offers walking meetings for persons with depression under supervision of an exercise instructor and a psychotherapist in each group, taking place at three sites in Rhineland–Palatinate. The project was evaluated in a pilot phase of one year.

Methods

Standardized and self-developed questionnaires were used to gather data on different physical and psychological dimensions. Furthermore, the participants were asked to evaluate the project themselves.

Results

A total of 36 participants filled in questionnaires at the beginning and at the end of the project. Significant improvements could be shown with regard to physical and psychological well-being, depression and self-efficacy as well as improvements of the physical and psychological well-being after every walking session. The evaluation of the project by the participants turns out positive almost without exception.

Conclusions

Walking meetings with supervision of an exercise and a psychotherapeutic professional seem to have a positive impact for persons with depression. The experience that walking feels good and especially the effects of a common activity in a group have to be pointed out.

     

Simple Interactions: Piloting a Strengths-Based and Interaction-Based Professional Development Intervention for Out-of-School Time Programs

Background

Adult–child relational interactions constitute an essential component of out-of-school-time programs, and training staff to effectively interact with children is key to improving program quality. Efficient staff training, that meets the limited time availability of out-of-school time staff, is particularly needed.

Objective

This pilot study introduces Simple Interactions (SI), an innovative, strengths-based, and interaction-based professional development approach. Rather than attempting to teach generic competencies or targeting weakness areas for improvement, SI is designed to help program staff build from their strengths.

Methods

In two cohorts over the course of 10 months, ten afterschool programs (N = 70 staff) participated in a pilot of SI. Program staff watched short video clips of themselves working with children and used the intuitive, 1-page SI Tool to guide discussion of adult–child interactions; specifically, connection (affective intune-ness), reciprocity (balanced roles of engagement), participation (involving all children), and progression (incremental challenge).

Results

Results suggest that participants valued the professional development process, the strengths-based approach, and the use of self-video despite initial apprehension, and reported perceived improvements in their professional learning communities. Pre-post videos of Cohort 2 staff (n = 20), coded blind to time point (pre or post), indicate significant and substantive improvements in staff–child connection, reciprocity, and participation.

Conclusion

These results support the use of this simple, practical, and potentially effective model of supporting quality improvement for and by local staff.

     

Adverse Childhood Experiences,Coping Resources,and Mental Health Problems among Court-Involved Youth

Background

Mental health problems are gaining attention among court-involved youth with emphasis on the role of childhood adversity, but assessment lags.

Objective

The present study uses a commonly delivered assessment tool to examine mental health problems (current mental health problem, mental health interfered with probation goals, and suicide ideation) as a function of an expanded set of adverse childhood experiences (ACEs; childhood maltreatment, family dysfunction, and social disadvantage). Adaptive coping resources–impulse control, aspirations, and social support–were tested as both direct contributors and moderators of the influence of ACEs on mental health.

Methods

Using a diverse sample of youth on probation (N = 5378), this study utilized logistic regression models to test contributions of the three domains of childhood adversity–childhood maltreatment, family dysfunction, and social disadvantage. These models also examined the moderating roles of coping resources.

Results

Childhood maltreatment emerged as the strongest contributor to mental health problems, with significant moderation from social support. Youth aspirations were inversely related to mental health problems and moderated the relation with ACEs and mental health problems that interfered with probation.

Conclusions

Assessment and mitigation of the detrimental effects of childhood maltreatment are important considerations in the intervention programs that target mental health outcomes of court-involved youth. Intervention programs to prevent recidivism and improve mental health should improve impulse control and aspirations.

     

Individuals’ quality of life linked to major life events,perceived social support,and personality traits

Purpose

The aim of this study was to investigate the relationship between major recent life events that occurred during the last 5 years, social and personal resources, and subjective quality of life (QoL).

Methods

A total of 1801 participants from the general population (CoLaus/PsyCoLaus study) completed the Life Events Questionnaire, the Social Support Questionnaire, the NEO Five-Factor Inventory Revised, and the Manchester Short Assessment of Quality of Life.

Results

Major life events were modestly associated with the QoL (about 5 % of the explained variance). However, QoL was significantly related to perceived social support and personality traits (about 37 % of the explained variance). Particularly, perceived social support, extraversion and conscientiousness personality dimensions were positively linked to life satisfaction, whereas a high level of neuroticism was negatively associated with QoL.

Conclusion

This study highlights the negative but temporary association between critical events and QoL. However, a combination of high conscientiousness and extraversion, and positive social support may explain better variances for a high-perceived QoL.

     

A Randomized Controlled Trial of an Online Relapse Prevention Program for Adolescents in Substance Abuse Treatment

Background

An Internet-based relapse prevention supplement to adolescent substance abuse treatment programming is a promising modality to reinforce treatment gains and enhance recovery; however, an evidence base is lacking.

Objective

To assess the efficacy of the online Navigating my Journey (NmJ) program.

Methods

129 adolescent-aged participants (ages 13–23) receiving substance abuse treatment participated in a randomized parallel group study comparing two conditions: experimental (NmJ) versus attention control (viewed wellness articles from the Nemours Foundation at their discretion). Participants in the experimental condition were asked to complete 12 core lessons over 3 months. Lesson content was developed to teach evidence-based relapse prevention skills. Data were collected at four time points: baseline, 1-month follow up, 3-month follow up, and 6-month follow up.

Results

We used a linear mixed modeling approach to test for differences between conditions on each outcome. Participants in the experimental condition reported a significantly greater increase in motivation to reduce or not misuse drugs from baseline to 3-month follow up and from baseline to 6-month follow up, compared to the control participants. Participants in the experimental condition also reported a greater decrease in drug use score from baseline to 3-month follow up, compared to the control participants. An analysis of age as a potential moderator suggested that the intervention may be more effective for older adolescents. Greater use of the program was associated with greater self-efficacy and lower self-reported substance use over time.

Conclusions

Relapse prevention treatment with adolescents may be facilitated by theory-based online interventions.

ClinicalTrials.gov Identifier

NCT02125539.

     

Descriptive self-reporting survey of people with idiopathic environmental intolerance attributed to electromagnetic fields (IEI-EMF): similarities and comparisons with previous studies

Context

In France, cases of people self-reporting symptoms due to electromagnetic fields (EMF) or idiopathic environmental intolerance attributed to electromagnetic fields (IEI-EMF) have emerged over the past 10 years. Several self-help and action groups have claimed an increasing number of members. However, little is known about this population in France.

Aim

Our primary objective was to describe the reported symptoms and the sources that may induce these symptoms through a questionnaire-based study. Secondly, we discussed our results alongside those obtained from the existing literature and provide an overview of this physical condition.

Subjects and methods

From April to November 2014, a self-questionnaire survey was conducted in France. With 52 participants, the average age of respondents was 50?±?11 years and the majority of participants at 79% were women.

Results

Our study results in the French population were consistent with findings in the literature conducted in other countries and also highlighted a number of emerging EMF sources such as wireless area networks, to be perceived as possible causes of symptoms.

Conclusions

Despite methodological differences, we summarized facts from previous comparable investigations. We also provided an overview of people claiming EMF effects and briefly discussed possible avenues of research.