Motives for Suicide Attempts--the Views of the Patients

This study was designed to investigate the motives patients give for attempting suicide and the associations between these motives and diagnosis, various psychiatric features, suicidal intent and socio-demographic characteristics. The Motives for Parasuicide Questionnaire (MPQ), comprising 14 suggested motives, was presented to 53 patients at a psychiatric ward that specialized in suicide attempters. Escape motives were very common, whereas interpersonal motives were rare. Patients with substance abuse, anxiety, or personality disorders more often chose communicating motives and mentioned higher numbers of motives than those with mood or adjustment disorders. Hopelessness was positively associated with a stated wish to die and with escape motives, and negatively correlated to communicating/unclear motives. Suicidal intent was related to some motives. The psychiatric disorder or mental state seems to be more important than socio-demographic characteristics for the choice of motives. Further studies are required to investigate the associations between psychiatric features and motives, as well as the clinical usefulness of such assessments.     

Suicidal ideation and behavior in institutions of higher learning: A latent class analysis

Suicide is the second leading cause of death among undergraduate students, with an annual rate of 7.5 per 100,000. Suicidal behavior (SB) is complex and heterogeneous, which might be explained by there being multiple etiologies of SB. Data-driven identification of distinct at-risk subgroups among undergraduates would bolster this argument. We conducted a latent class analysis (LCA) on survey data from a large convenience sample of undergraduates to identify subgroups, and validated the resulting latent class model on a sample of graduate students. Data were collected through the Interactive Screening Program deployed by the American Foundation for Suicide Prevention. LCA identified 6 subgroups from the undergraduate sample (N = 5654). In the group with the most students reporting current suicidal thoughts (N = 623, 66% suicidal), 22.5% reported a prior suicide attempt, and 97.6% endorsed moderately severe or worse depressive symptoms. Notably, LCA identified a second at-risk group (N = 662, 27% suicidal), in which only 1.5% of respondents noted moderately severe or worse depressive symptoms. When graduate students (N = 1138) were classified using the model, a similar frequency distribution of groups was found. Finding multiple replicable groups at-risk for suicidal behavior, each with a distinct prevalence of risk factors, including a group of students who would not be classified as high risk with depression-based screening, is consistent with previous studies that identified multiple potential etiologies of SB.     

长三角地区“双一流”高校大学生遭受虐待经历与自杀意念的关系

目的 了解长三角地区双一流高校大学生儿童期遭受虐待经历与自杀意念之间的关系，为双一流高校大学生身心健康发展提供帮助。方法 在长三角地区的三省一市选取8所双一流高校的2412名大学生进行虐待经历和自杀意念的问卷调查，并对结果进行〖XC小五号.EPS;P〗检验、logistic回归分析。结果 双一流高校大学生儿童时期遭受1种及以上虐待经历的人数占43.99%。其中躯体虐待、情感虐待、性虐待、躯体忽视、情感忽视的比例分别为12.11%、6.67%、17.21%、36.40%和21.43%。大学生自杀意念报告率为3.94%。情感忽视（OR=2.08）、躯体忽视（OR=2.19）与大学生自杀意念存在正相关（P值均＜0.01）。结论 大学生在儿童期遭受躯体和情感忽视与自杀意念相关，预防儿童期虐待经历有助于预防大学阶段产生自杀意念。     

Clinical characteristics and functions of non-suicide self-injury in youth

PurposeLittle is known about the clinical characteristics and motivations for engaging in non-suicide self-injury (NSSI) behaviors in adolescence. The aim of this study was to examine the prevalence, characteristics and functions of NSSI among adolescents in community settings, and to explore risk factors related to this behavior.Subjects and methodsTwo hundred and seventy-five adolescents aged 12 to 17 were recruited randomly from different High Schools in Israel. They completed self-report questionnaires assessing NSSI (Ottawa Self-Injury Inventory), depression (Children's Depression Inventory – CDI) and impulsivity (Barratt Impulsiveness Scale – BIS-II).ResultsIn the past year, 20.7% of the participants reported engaging NSSI at least once. Among them, 42.1% declared they are still engaging in NSSI at the present. Motives for NSSI were internal emotion regulation reasons, external emotion regulation reasons for social influences. In addition, the NSSI group reported significantly higher levels of depressive, impulsivity and suicidal ideations. Depressive symptoms were found as significant predictors of NSSI in the future.Discussion and conclusionsHigh rates of NSSI among community adolescents were found. Depression, impulsivity and suicidal ideation were found significantly related to NSSI. Mental health professionals in schools and in primary care should routinely assess NSSI among adolescents.     

Dispositifs de prévention et de postvention du suicide en prison mis en place par l’Administration Pénitentiaire française

The French Prison Administration has been doing suicide prevention in prison for over 50 years. It is undoubtedly one of the administrations, which best takes these risks into account today. She even made it one of her priorities. On the one hand, by developing an initial and continuous training system on this subject, and on the other hand, by implementing preventive measures based on the assessment of the suicidal potential of anyone arriving in prison. It has thus set up prevention and postvention devices in the face of its own suicide risk. While all of these measures give encouraging signs in terms of results, the fact remains that a certain number of deaths by suicide in prison still occur each year. It is therefore necessary for the prison administration to also take postvention measures in order to minimize the psychological impact on prisoners and on personnel directly concerned by the discovery of a suicide prisoner. The prison staff has an obligation of means with regard to the medical care of detained persons. Several legal texts, European and French, legislate this obligation and lay down the broad outlines. The prevention of suicidal risks in the prison environment is based on the assessment of the suicidal potential of detained persons, upon their arrival in detention. Each inmate is assessed for the risk, urgency and suicidal dangerousness he presents during this incoming interview. Depending on the results, measures specific to the prison administration can be taken to limit, or even prevent, any risk of suicide. All personnel in initial training at the national school of prison administration (ENAP) are made aware of this evaluation method. There after, additional training, throughout their career, is offered to them in continuous training so that they develop their skills in this area. But when a suicide, or an attempt, occurs in detention, postvention measures are put in place for all those affected by this event, in particular prison staff, fellow prisoners and families. The prison administration has been working on suicide prevention in detention for over fifty years, making it one of the French administrations most involved in suicide prevention.     

Suicidalité chez les adolescents appartenant au spectre de l’autisme

Suicidal behaviors are clinically mentioned in children and adolescents with autism spectrum disorder (ASD). But clinical research in this field is very limited and the diagnosis is not considered in emergency units. In clinical populations of adolescents with an ASD, suicidality was found with a frequency of 11–20%. One of the major individual risk factors to look for is the depressive disorder. However, the diagnosis is quite difficult to make because of the common features between ASD and depression. Self-assessment of suicidality and depression or anxiety remains unreliable, suggesting the need of external observers. The bullying and social integration problems are some important concerns in this population, because they are considered as predisposing factors pushing to commit suicide. Further clinical research in suicidal behaviors in adolescent with ASD will lead to develop targeted therapeutic interventions.